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Published in: European Archives of Oto-Rhino-Laryngology 7/2016

01-07-2016 | Head and Neck

Parathyroid function following total thyroidectomy using energy devices

Authors: Fatih Ciftci, Erdal Sakalli, Ibrahim Abdurrahman, Burak Guler

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2016

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Abstract

LigaSure precise (LP) and harmonic scalpel (HS) are two energy-based devices used in thyroidectomy surgery. We aimed to compare the effect of these two devices in patients who had undergone total thyroidectomy, by highlighting the post-operative parathyroid function. A total of 201 consecutive patients for whom total thyroidectomy had been planned were prospectively classified into two groups. There were 104 patients in LP group and 97 patients in HS group. Hypoparathyroidism was followed up by serially measuring the levels of intact parathyroid hormone (iPTH) and serum calcium. The early iPTH level was 29 (8–50) pg/mL in group LP, and 17 (4–43) pg/mL in group HS. The early iPTH level was significantly lower in the HS group (p < 0.001). However, these levels were within the reference interval in both groups. The early iPTH level was lower than 20 pg/mL in 23 (23.1 %) patients in HS group, and 15 (13.7 %) patients in LP group (p < 0.001). Also, the late iPTH levels were not statistically significance between two groups. The early and late serum calcium levels were not statistically significant between groups. However, the amount of calcium replacement was higher in the HS group than the LP group and the duration of treatment was longer in the HS group than the LP group (p < 0.05). In conclusion, although parathyroid hormone levels impaired in the HS group more than LP group in the early period, these levels were in the normal limits in both groups. These levels were not significant between groups in the long time period.
Literature
1.
go back to reference Dionigi G, Bacuzzi A, Boni L, Rovera F, Piantanida E, Tanda ML, Diurni M, Carcano G, Luigi B, Cuffari S, Dionigi R (2005) Influence of new technologies on thyroid surgery: state of the art. Expert Rev Med Devices 2(5):547–557CrossRefPubMed Dionigi G, Bacuzzi A, Boni L, Rovera F, Piantanida E, Tanda ML, Diurni M, Carcano G, Luigi B, Cuffari S, Dionigi R (2005) Influence of new technologies on thyroid surgery: state of the art. Expert Rev Med Devices 2(5):547–557CrossRefPubMed
2.
go back to reference Dralle H (2006) Impact of modern technologies on quality of thyroid surgery. Langenbecks Arch Surg 391(1):1–3CrossRefPubMed Dralle H (2006) Impact of modern technologies on quality of thyroid surgery. Langenbecks Arch Surg 391(1):1–3CrossRefPubMed
3.
go back to reference Kirdak T, Korun N, Ozguc H (2005) Use of ligasure in thyroidectomy procedures: results of a prospective comparative study. World J Surg 29:771–774CrossRefPubMed Kirdak T, Korun N, Ozguc H (2005) Use of ligasure in thyroidectomy procedures: results of a prospective comparative study. World J Surg 29:771–774CrossRefPubMed
4.
go back to reference Yilmaz KB, Dogan L, Nalbant H, Akinci M, Karaman N, Ozaslan C, Kulacoglu H (2011) Comparing scalpel, electrocautery and ultrasonic dissector effects: the impact on wound complications and pro-inflammatorycytokine levels in wound fluid from mastectomy patients. J Breast Cancer 14:58–63CrossRefPubMedPubMedCentral Yilmaz KB, Dogan L, Nalbant H, Akinci M, Karaman N, Ozaslan C, Kulacoglu H (2011) Comparing scalpel, electrocautery and ultrasonic dissector effects: the impact on wound complications and pro-inflammatorycytokine levels in wound fluid from mastectomy patients. J Breast Cancer 14:58–63CrossRefPubMedPubMedCentral
5.
go back to reference Franko J, Kish KJ, Pezzi CM, Pak H, Kukora JS (2006) Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure) versus conventional clamp-and-tie technique. Am Surg 72(2):132–136PubMed Franko J, Kish KJ, Pezzi CM, Pak H, Kukora JS (2006) Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure) versus conventional clamp-and-tie technique. Am Surg 72(2):132–136PubMed
6.
go back to reference Sartori PV, De Fina S, Colombo G et al (2008) Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 393:655–658CrossRefPubMed Sartori PV, De Fina S, Colombo G et al (2008) Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 393:655–658CrossRefPubMed
7.
go back to reference Miccoli P, Berti P, Dionigi G, D’Agostino J, Orlandini C, Donatini G (2006) Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 132:1069–1073CrossRefPubMed Miccoli P, Berti P, Dionigi G, D’Agostino J, Orlandini C, Donatini G (2006) Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 132:1069–1073CrossRefPubMed
8.
go back to reference Pons Y, Gauthier J, Ukkola-Pons E et al (2009) Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg 141:496–501CrossRefPubMed Pons Y, Gauthier J, Ukkola-Pons E et al (2009) Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg 141:496–501CrossRefPubMed
9.
go back to reference Manouras A, Markogiannakis H, Koutras AS et al (2008) Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg 195:48–52CrossRefPubMed Manouras A, Markogiannakis H, Koutras AS et al (2008) Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg 195:48–52CrossRefPubMed
10.
go back to reference D’Ajello F, Cirocchi R, Docimo G et al (2010) Thyroidectomy with ultrasonic dissector: a multicentric experience. G Chir 31:289–292PubMed D’Ajello F, Cirocchi R, Docimo G et al (2010) Thyroidectomy with ultrasonic dissector: a multicentric experience. G Chir 31:289–292PubMed
11.
go back to reference Wells SA Jr, Gunnels JC, Shelburne JD, Schneider AB, Sherwood LM (1975) Transplantation of the parathyroid glands in man: clinical indications and result. Surgery 78:34–44PubMed Wells SA Jr, Gunnels JC, Shelburne JD, Schneider AB, Sherwood LM (1975) Transplantation of the parathyroid glands in man: clinical indications and result. Surgery 78:34–44PubMed
12.
go back to reference Scium C, Geraci G, Pisello F et al (2006) Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment. Ann Ital Chir 77:115–122 Scium C, Geraci G, Pisello F et al (2006) Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment. Ann Ital Chir 77:115–122
13.
go back to reference Demeester-Mirkine N, Hooghe L, Van Geertruyden J, De Maertelaer V (1992) Hypocalcemia after thyroidectomy. Arch Surg 127:854–857CrossRefPubMed Demeester-Mirkine N, Hooghe L, Van Geertruyden J, De Maertelaer V (1992) Hypocalcemia after thyroidectomy. Arch Surg 127:854–857CrossRefPubMed
14.
go back to reference Australian Endocrine Surgeons Guidelines AES06/01(2007) Postoperative parathyroid hormone measurement and early discharge after total thyroidectomy: analysis of Australian data and mangement recommendations. ANZ J Surg 77:199–202 Australian Endocrine Surgeons Guidelines AES06/01(2007) Postoperative parathyroid hormone measurement and early discharge after total thyroidectomy: analysis of Australian data and mangement recommendations. ANZ J Surg 77:199–202
15.
go back to reference Dionigi G, Bacuzzi A, Bertocci V et al (2008) Prospectives and surgical usefulness of perioperative parathyroid hormone assay in thyroid surgery. Expert Rev Med Devices 5:699–704CrossRefPubMed Dionigi G, Bacuzzi A, Bertocci V et al (2008) Prospectives and surgical usefulness of perioperative parathyroid hormone assay in thyroid surgery. Expert Rev Med Devices 5:699–704CrossRefPubMed
16.
go back to reference Barczyniski M, Cichon S, Konturek A (2007) Which criterion of intraoperative iPTH assay is the most accurate in prediction of true serum calcium levels after thyroid surgery? Langenbacks Arch Surg 392:693–698CrossRef Barczyniski M, Cichon S, Konturek A (2007) Which criterion of intraoperative iPTH assay is the most accurate in prediction of true serum calcium levels after thyroid surgery? Langenbacks Arch Surg 392:693–698CrossRef
18.
go back to reference Sywak MS, Palazzo FF, Yeh M et al (2007) Parathyroid hormone assay predicts hypocalcemia after total thyroidectomy. ANZ J Surg 77:667–670CrossRefPubMed Sywak MS, Palazzo FF, Yeh M et al (2007) Parathyroid hormone assay predicts hypocalcemia after total thyroidectomy. ANZ J Surg 77:667–670CrossRefPubMed
19.
go back to reference Lindblom P, Westerdahl J, BernenTelz A (2002) Low parathyroid hormone levels after thyroid surgery: a feasible predictor of hypocalcemia. Surgery 131:515–520CrossRefPubMed Lindblom P, Westerdahl J, BernenTelz A (2002) Low parathyroid hormone levels after thyroid surgery: a feasible predictor of hypocalcemia. Surgery 131:515–520CrossRefPubMed
20.
go back to reference Bliss RD, Gauger PG, Delbridge LW (2000) Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg 24:891–897CrossRefPubMed Bliss RD, Gauger PG, Delbridge LW (2000) Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg 24:891–897CrossRefPubMed
21.
go back to reference Smith CT, Zarebczan B, Alhefdhi A, Chen H (2011) Infrared thermographic profiles of vessel sealing devices on thyroid parenchyma. J Surg Res 170(1):64–68CrossRefPubMedPubMedCentral Smith CT, Zarebczan B, Alhefdhi A, Chen H (2011) Infrared thermographic profiles of vessel sealing devices on thyroid parenchyma. J Surg Res 170(1):64–68CrossRefPubMedPubMedCentral
22.
go back to reference Dionigi G, Boni L, Rovera F, Dionigi R (2006) Thyroid surgery:new approach to dissection and hemostasis. Surg Technol Int 15:75–80PubMed Dionigi G, Boni L, Rovera F, Dionigi R (2006) Thyroid surgery:new approach to dissection and hemostasis. Surg Technol Int 15:75–80PubMed
23.
go back to reference Campell PA, Cresswell AB, Frank TG, Cuschieri A (2003) Real-time thermography during energized vessel sealing and dissection. Surg Endosc 17:1640–1645CrossRef Campell PA, Cresswell AB, Frank TG, Cuschieri A (2003) Real-time thermography during energized vessel sealing and dissection. Surg Endosc 17:1640–1645CrossRef
Metadata
Title
Parathyroid function following total thyroidectomy using energy devices
Authors
Fatih Ciftci
Erdal Sakalli
Ibrahim Abdurrahman
Burak Guler
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 7/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-015-3704-8

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