ES17 *RESULTS OF SUTURELESS TECHNIQUES VS CONVENTIONAL VESSEL LIGATION FOR TOTAL THYROIDECTOMY

Abstract

Aim: Advanced vessel sealing devices provide an alternative to conventional ligation techniques. Studies into sutureless thyroidectomy (ST) suggest advantages with reduction in operative time, but most were inadequately powered to explore differences in postoperative complications which should be approximately 1%. This study is designed to compare the outcomes of ST and conventional thyroidectomy (CT) for recurrent laryngeal nerve (RLN) injury, permanent hypoparathyroidism and haematoma formation.Method: A cohort study of consecutive patients undergoing total thyroidectomy using conventional vs. sutureless techniques was performed. ST was performed using either Ligasure Precise or Harmonic Focus devices. The primary outcome measures were postoperative haemorrhage, permanent RLN injury and hypoparathyroidism. Secondary outcome measures were operative time, temporary hypoparathyroidism and vocal cord dysfunction.Result: From January 2007 to December 2008, 1449 consecutive patients underwent total thyroidectomy. Of these 725 underwent CT and 724 were performed using ST. The mean operative time was significantly lower in the ST group (44.2 vs. 57.3 min. p = 0.032). There was no difference in postoperative haematoma incidence between groups 0.8% CT vs. 0.7% ST, p = 0.89. The permanent hypoparathyroidism rate was not significantly different between groups 1.2% CT versus 0.4% ST, p = 0.08. There was no difference in the incidence of permanent RLN injury 0.2%CT and 0.4%ST, p = 0.31.Conclusion: Sutureless total thyroidectomy using advanced vessel sealing technology is safe and efficient and has complication rates equivalent to conventional techniques.