Differences in Surgical Outcome in Near Total Thyroidectomy for Benign Nodular Goiter: A Comparison of LigaSure Vessel Sealer versus Conventional Clamp Knot Tie Technique
Shiraz Shaikh *
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
Champa Sushel
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
Ahsan Ali Laghari
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
Qamber Ali Laghari
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
Zameer Hussain Laghari
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
Aisha Memon
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage.
Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique. Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20.
Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001).
Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.
Keywords: Near total thyroidectomy, Ligasure vessel sealer, clamp knot tie