Abstract

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage.
 Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique. Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20.
 Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001).
 Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

Highlights

  • Multinodular goitre is a thyroid pathology that is encountered most frequently, for which; surgical intervention remains the most effective therapeutic choice [1,2,3,4]

  • Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-

  • Near total thyroidectomy been performed in all cases, so usually parathyroid glands along with normal rim of thyroid gland has been preserved

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Summary

Introduction

Multinodular goitre is a thyroid pathology that is encountered most frequently, for which; surgical intervention remains the most effective therapeutic choice [1,2,3,4]. At most facilities, standardized vessel ligation with suture ligatures and ties has become the standard procedure. LigaSure is a vascular sealing bipolar system that induces fusion of elastin and collagen in vessels as well as underlying tissues, allowing for vascular hemostasis around 7 mm and greatly reduces procedure time [8,9,10]. It has been proposed as a substitute to the traditional knotting procedure and has been successfully used for surgical procedure of thyroid [1,11,12]

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