Comparison of Starion Vessel Sealing System with Conventional Technique and Harmonic Focus Ultrasonic Scalpel in Total Thyroidectom

Abstract

Aim: This study compares the use of Starion Tissue Welding SystemTM (STWS) in patients who underwent total thyroidectomy due to Multinodular Goiter (MNG) with the conventional technique and Harmonic Focus Ultrasonic ScalpelTM (HFUS) in terms of operation time, bleeding during and after the operation, and complications. Materials and Methods: Between June 2013 and August 2014, 60 patients who underwent a total thyroidectomy due to MNG were retrospectively analyzed. The patients were divided into three groups according to the surgical method. Each group consisted of 20 patients. In the operations, ligation/coagulation and cutting procedures were performed to middle thyroid veins, upper and lower pole arteries/veins of the thyroid gland using conventional clamp and-tie technique in Group-A, STWS in Group-B, and HFUS in Group-C. Groups were compared regarding the operation time, the amount of bleeding during and after the operation, and the complications encountered. Results: Operation times were established as 63.25±28.66 minutes in Group-A, 42.60±20.14 minutes in Group-B, and 49.60±9.17 minutes in Group-C (p˂0.05). Perioperative bleeding was 93.50±56.05 ml in Group-A, 25.60±15.21 ml in Group-B, and 62.50±23.31 ml in Group-C (p˂0.05). Postoperative blood drainage was 124.50±153.09 ml, 8.75±11.68 ml, and 35.75±25.91 ml, respectively (p˂0.05). Regarding hemostasis, while two patients in Group-A required hemostasis within the first 24 hours, there was no need for hemostasis in Group-B and Group-C (p=0.12). The blood calcium levels measured on the first postoperative day were found to be 8.39±0.56 mg/dl in Group-A, 8.34±1.14 mg/dl in Group-B, 8.37±0.78 mg/dl in Group-C (p=0.86). Blood parathormone levels measured on the first postoperative day were 52.72±35.85 pg/dl, 34.77±20.0 pg/dl, and 56.41±36.56 pg/dl, respectively (p=0.09). Conclusion: STWS can be used safely in thyroid surgery because it reduces bleeding during and after surgery, shortens the operation time, and has low complication rates.

Keywords

• thyroidectomy
• tissue welding system
• ultrasonic device
• clamp and tie

References

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