COMPARISON OF THE EFFECTS OF FOCUS HARMONIC SCALPEL AND CONVENTIONAL HAEMOSTASIS ON PARATHYROID FUNCTION IN THYROID SURGERY

Authors

  • Sheng-Qian Xu Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine
  • Yi Ma Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine
  • Hong-Wei Su Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine
  • Jian-Feng Cheng Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine
  • You-Xing Zhou Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

Abstract

Background: Protection of parathyroid is very important in thyroid surgery. Our aim was to compare the effect of Focus Harmonic Scalpel and Conventional Haemostasis on parathyroid function in thyroid surgery. Methods: To analyse the clinical data of patients in our hospital from November 2011～December 2015 retrospectively. Operations has been performed with Focus Harmonic Scalpel in thyroid surgery since May 2013. Seventy-four patients with nodular goitre constituted Harmonic Scalpel group and Conventional Haemostasis group, and so did 139 patients with thyroid papillary carcinoma. Clinical data were compared such as age, gender, thyroid volume, operation procedure, preoperative parathyroid hormone and serum calcium concentration between the two groups. The differences between the two groups were observed in serum calcium concentration, parathyroid hormone concentration, incidence of transient hypocalcaemia and hypoparathyroidism after operation. Results: The preoperative data showed no significant difference between Harmonic Scalpel group and Conventional Haemostasis group. No significant difference existed in postoperative clinic data at six a.m. the first day after operation between the two groups for patients with nodular goitre. The incidence of transient hypoparathyroidism and hypocalcaemia in Harmonic Scalpel group were less than that in Conventional Haemostasis group in thyroid surgery. Significant differences existed in the mean of serum calcium concentration and incidence of transient hypocalcaemia between the two groups for thyroid papillary carcinoma statistically. Conclusions: Focus Harmonic Scalpel has certain advantages than conventional Haemostasis in protecting parathyroid glands, reducing the incidence of transient hypoparathyroidism and hypocalcaemia in thyroid surgery, especially for patients with thyroid cancer.Keywords: Thyroidectomy; Focus Harmonic Scalpel; Hypoparathyroidism; Hypocalcaemia

Author Biographies

Sheng-Qian Xu, Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

Department of General Surgery，Associate chief physician

Yi Ma, Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

 Department of General Surgery，Associate chief physician

Hong-Wei Su, Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

Department of General Surgery，Associate chief physician

Jian-Feng Cheng, Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

Department of General Surgery，Associate chief physician

You-Xing Zhou, Affiliated to Jiangyuan Hospital, Jiangsu Institute Of Nuclear Medicine

Department of General Surgery,physician

References

Coimbra C,Monteiro F,Oliveira P,Ribeiro L,de Almeida MG,Condé A.Hypoparathyroidism following thyroidectomy:Predictive factors.Acta Otorrinolaringol Esp 2017;68(2):106-111.

Moreno P,Francos JM,García-Barrasa A,Fernández-Alsina E,de Lama E,Martínez R,et al.Efficacy and budget impact of the Focus harmonic scalpel compared to the ACS-14C device in total thyroidectomy due to multinodular goitre. A prospective randomised study. Cir Esp. 2013;91(10):664-71.

Markogiannakis H,Kekis PB,Memos N, Alevizos L, Tsamis D, Michalopoulos NV,et al.Thyroid surgery with the new harmonic scalpel: a prospective randomized study.Surgery.2011;149(3):411-5.

Bandi G,Wen CC,Wilkinson EA,Hedican SP,Moon TD,Nakada SY.Comparison of blade temperature dynamics after activation of Harmonic Ace scalpel and the Ultracision Harmonic Scalpel LCS-K5.J Endourol.2008;22(2):333–6.

Ferri E, Armato E, Spinato G, Spinato R.Focus Harmonic Scalpel Compared to Conventional Haemostasis in Open Total Thyroidectomy:A Prospective Randomized Trial.Int J Otolaryngol.2011;2011(9):1-7.

Yano Y,Masaki C,Sugino K, Nagahama M, Kitagawa W, Sibuya H, et al.Serum intact parathyroid hormone level after total thyroidectomy or total thyroidectomy plus lymph node dissection for thyroid nodules:report from 296 surgical cases.Int J Endocrinol Metab.2012;10(4):594-8.

Pelizzo MR,Sorgato N,Isabella Merante Boschin I,Marzola MC,Colletti PM,Rubello D.Does the ultrasound dissector improve parathyroid gland preservation during surgery? Eur J Surg Oncol.2014;40(7):865-8.

Duan YF,Xue W, Zhu F,Sun DL.FOCUS harmonic scalpel compared to conventional hemostasis in open total thyroidectomy–a prospective randomized study.J Otolaryngol Head Neck Surg.2013;20(42):62-6.

Grodski S,Serpell J.Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia.World J Surg.2008;32(7):1367–73.

De Palma M,Rosato L,Zingone F ,Orlando G, Antonino A, Vitale M,et al.Post-thyroidectomy complications.The role of the device: bipolar vs ultrasonic device:Collection of data from 1,846 consecutive patients undergoing thyroidectomy.Am J Surg.2016;212(1):116-21.

Prgomet D,Janjanin S,Bilić M,et al.A prospective observational study of 363 cases operated with three different harmonic scalpels.Eur Arch Otorhinolaryngol .2009;266:1965-70.

Lorente-Poch L,Sancho JJ,Ruiz S,Sitges-Serra A.Importance of in situ preservation of parathyroid glands during total thyroidectomy.Br J Surg.2015;102:359-67.

Trupka A, Sienel W.Autotransplantation of at least one parathyroid gland during thyroidectomy in benign thyroid disease minimizes the risk of permanent hypoparathyroidism.Zentralbl Chir.2002;127:439-42.1. Coimbra C, Monteiro F, Oliveira P, Ribeiro L, de Almeida MG, Condé A. Hypoparathyroidism following thyroidectomy: Predictive factors. Acta Otorrinolaringol Esp 2017;68(2):106–11.

Ruggiero R, Docimo G, Bosco A, Lanza Volpe M, Terracciano G, Gubitosi A, et al. Update on sutureless thyroidectomy. G Chir 2018;39(1):45–50.

Revelli L, Damiani G, Bianchi CB, Vanella S, Ricciardi W, Raffaelli M, et al. Complications in thyroid surgery. Harmonic Scalpel, Harmonic Focus versus Conventional Hemostasis: A meta-analysis. Int J Surg 2016;28(Suppl 1):S22–32.

Cannizzaro MA, Lo Bianco S, Borzì L, Cavallaro A, Buffone A. The use of FOCUS Harmonic scalpel compared to conventional haemostasis (knot and tieligation) for thyroid surgery: a prospective randomized study. Springerplus 2014;28(3):639–43.

Maeda H, Kutomi G, Satomi F, Shima H, Mori M, Takemasa I. Comparison of surgical outcomes and complications between the Harmonic FOCUS and conventional surgery for open thyroidectomy. Mol Clin Oncol 2018;8(4):557–60.

Moreno P, Francos JM, García-Barrasa A, Fernández-Alsina E, de Lama E, Martínez R, et al. Efficacy and budget impact of the Focus harmonic scalpel compared to the ACS-14C device in total thyroidectomy due to multinodular goitre. A prospective randomized study. Cir Esp 2013;91(10):664–71.

Markogiannakis H, Kekis PB, Memos N, Alevizos L, Tsamis D, Michalopoulos NV, et al. Thyroid surgery with the new harmonic scalpel: a prospective randomized study. Surgery 2011;149(3):411–5.

Bandi G, Wen CC, Wilkinson EA, Hedican SP, Moon TD, Nakada SY. Comparison of blade temperature dynamics after activation of Harmonic Ace scalpel and the Ultracision Harmonic Scalpel LCS-K5. J Endourol 2008;22(2):333–6.

Ferri E, Armato E, Spinato G, Spinato R. Focus Harmonic Scalpel Compared to Conventional Haemostasis in Open Total Thyroidectomy: A Prospective Randomized Trial. Int J Otolaryngol 2011;2011(9):357195.

Yano Y, Masaki C, Sugino K, Nagahama M, Kitagawa W, Sibuya H, et al. Serum intact parathyroid hormone level after total thyroidectomy or total thyroidectomy plus lymph node dissection for thyroid nodules:report from 296 surgical cases. Int J Endocrinol Metab 2012;10(4):594–8.

Pelizzo MR, Sorgato N, Isabella Merante Boschin I, Marzola MC, Colletti PM, Rubello D. Does the ultrasound dissector improve parathyroid gland preservation during surgery? Eur J Surg Oncol 2014;40(7):865–8.

Duan YF, Xue W, Zhu F, Sun DL. FOCUS harmonic scalpel compared to conventional hemostasis in open total thyroidectomy–a prospective randomized study. J Otolaryngol Head Neck Surg 2013;20(42):62–6.

Grodski S, Serpell J. Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia. World J Surg 2008;32(7):1367–73.

De Palma M, Rosato L, Zingone F, Orlando G, Antonino A, Vitale M, et al. Post-thyroidectomy complications. The role of the device: bipolar vs ultrasonic device: Collection of data from 1,846 consecutive patients undergoing thyroidectomy. Am J Surg 2016;212(1):116–21.

Prgomet D, Janjanin S, Bilić M, Prstacic R, Kovac L, Rudes M, et al. A prospective observational study of 363 cases operated with three different harmonic scalpels. Eur Arch Otorhinolaryngol 2009;266(12):1965–70.

Lorente-Poch L, Sancho JJ, Ruiz S, Sitges-Serra A. Importance of in situ preservation of parathyroid glands during total thyroidectomy. Br J Surg 2015;102(4):359–67.

Trupka A, Sienel W. Autotransplantation of at least one parathyroid gland during thyroidectomy in benign thyroid disease minimizes the risk of permanent hypoparathyroidism. Zentralbl Chir 2002;127(5):439–42.

Published

2019-09-27

Issue

Vol. 31 No. 4 (2019): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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