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Review paper

Comparison of postoperative bleeding using harmonic scalpel and LigaSure in thyroid surgery: a 15-year single-centre retrospective study

By
Charalampos Kaplanis ,
Charalampos Kaplanis

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Marina Michalaki ,
Marina Michalaki

Department of Endocrinology, University General Hospital of Patras , Patras , Greece

Konstantinos Bouchagier ,
Konstantinos Bouchagier

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Ioannis Maroulis ,
Ioannis Maroulis

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Dimitrios Filis ,
Dimitrios Filis

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Vasileios Leivaditis ,
Vasileios Leivaditis

Department of Cardiothoracic Surgery, University General Hospital of Patras , Patras , Greece

Ioannis Panagiotopoulos ,
Ioannis Panagiotopoulos

Department of Cardiothoracic Surgery, University General Hospital of Patras , Patras , Greece

Nikolas Drakos ,
Nikolas Drakos

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Angelos Samaras ,
Angelos Samaras

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Andreas Antzoulas ,
Andreas Antzoulas

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Francesk Mulita Orcid logo ,
Francesk Mulita
Contact Francesk Mulita

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Dimitrios Kehagias ,
Dimitrios Kehagias

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Christos Tsilivigkos ,
Christos Tsilivigkos

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Fotios Iliopoulos ,
Fotios Iliopoulos

Department of General Surgery, General University Hospital of Patras , Patras , Greece

Konstantinos Tasios ,
Konstantinos Tasios

Department of General Surgery, General University Hospital of Patras , Patras , Greece

Levan Tchabashvili ,
Levan Tchabashvili

Department of General Surgery, General University Hospital of Patras , Patras , Greece

Vasileios Papanikos ,
Vasileios Papanikos

Department of Otorhinolaryngology, General University Hospital of Patras , Patras , Greece

Elias Liolis ,
Elias Liolis

Department of Oncology, University General Hospital of Patras , Patras , Greece

Georgios-Ioannis Verras ,
Georgios-Ioannis Verras

Department of Surgery, University General Hospital of Patras , Patras , Greece

George Theofanis
George Theofanis

Department of General Surgery, University General Hospital of Patras , Patras , Greece

Abstract

Aim
Thyroidectomy is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and harmonic scalpel (HS) in 1653 total thyroidectomies between January 2008 and March of 2023, with regards to analysis of surgical bleeding complications duration the hospital stay and operative surgical time.
Methods
It is a retrospective analysis of a prospectively maintained database. Patients have been categorized into two groups:
Group A included 718 patients from January 2008 to May 2013 when LS was used, and the Group B included 935 patients from June 2013 to March 2023 when HS was used.
Results
From the total of 14 postoperative bleeding cases that occurred in patients of Group A, only in 4 of them it was necessary
to have a reoperation. The other 10 cases involved minor haemorrhages, while from the total of 6 postoperative bleeding cases that happened to patients of Group B, there were 4 cases that needed a reoperation (p-value >0.05) and 2 patients with minor haemorrhages. The postoperative evaluation of minor bleedings revealed statistically significant differences between the two groups (p-value < 0.05). The average hospital stay was similar in the two groups.
Conclusion
Both devices exhibit identical safety profiles in thyroidectomies specifically regarding major bleeding complications
that require reoperation. Additionally, HS was found to be more effective at achieving haemostasis, especially in the subgroup of patients with thyroid carcinoma. The results of the present study may be useful for high-volume centres performing numerous thyroidectomies every day.

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