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Web End = World J Surg (2016) 40:117123 DOI 10.1007/s00268-015-3270-7
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Web End = ORIGINAL SCIENTIFIC REPORT
Risk of Complications with Energy-Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study
Johan Carlander1,5 Philippe Wagner5 Oliver Gimm1,2 Erik Nordenstrm3
Svante Jansson4 Leif Bergkvist5 Kenth Johansson1,4,6
Published online: 15 October 2015 Socit Internationale de Chirurgie 2015
AbstractBackground Energy-based surgical devices (EBD) combining cutting and coagulation are increasingly used in thyroid surgery. However, there is a lack of information about potential benets and risk of complications outside controlled trials. The aims of this national multicenter register study were to describe the use of EDB, their potential effect on complication rates, and on operation time.
Materials and methods The Scandinavian Quality Register for Thyroid and Parathyroid surgery includes 35 surgical units in Sweden and covered 88 % of the thyroid procedures performed during 20082009. The use of the EBD was specically registered for 12 months, and 1297 patients were included. Surgically related complications and operation time were evaluated. The clamp-and-tie group (C-A-T) constituted the control group for comparison with procedures where EBD was used.
Results The thyroid procedures performed included C-A-T (16.6 %), bipolar electrosurgery (ES: 56.5 %), electronic vessel sealing (EVS: 12.2 %), and ultrasonic dissection (UD: 14.5 %). Mean operative time was longer with EVS (p \ 0.001) and shorter with UD (p \ 0.05) than in the other groups. The bipolar ES group and the EVS group had higher incidence of calcium treatment at discharge and after 6 weeks than the UD group. No signicant difference in nerve injury was found between the groups. There was a signicant more frequent use of topical hemostatic agents in the EBD group compared to C-A-T.
Conclusion In this national multicenter study, the use of UD shortened and EVS increased operating time. There was a higher risk of calcium treatment at discharge and after 6 weeks after use of EVS and bipolar ES than after UD use. There was a signicant more frequent use of topical hemostatic agents in the EBD groups compared to C-A-T.