LigaSure® versus Clamp Tie Technique for Thyroid Surgery; Decreased Operative Time versus Increased Inflammatory Effect: A prospective randomized study

Bircan H., Inal A., ÖZÇELİK Ü., Koc B., Demirag A., Moray G., ...Daha Fazla

European Review for Medical and Pharmacological Sciences, cilt.18, sa.14, ss.1997-2005, 2014 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 14
  • Basım Tarihi: 2014
  • Dergi Adı: European Review for Medical and Pharmacological Sciences
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1997-2005
  • Anahtar Kelimeler: IL-6, LigaSure®, Lymphocyte subsets, TNF-α, Total thyroidectomy, Vessel sealing systems
  • Lokman Hekim Üniversitesi Adresli: Evet

Özet

OBJECTIVE: The aim of this study was to compare the LigaSure® Small Jaw Instrument (LSJI) with the conventional clampand-tie (CT) technique in thyroid surgery regarding complication rates (hematoma, hypocalcemia and recurrent nerve palsy), the duration of the operative procedure, and systemic and local inflammatory effects. PATIENTS AND METHODS: Fifty-four consecutive patients were randomized prospectively into two groups, a Conventional Clamp-Tie (CT) group and a LigaSure® Vessel Sealing System (LVSS) Group. Pre-and postoperative blood plasma samples were taken to measure the tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), calcium, parathormon, CRP levels and WBC, as well as the lymphocyte subset (CD3, CD4, CD8, CD16/56, CD19) counts. The drain fluid samples were collected after the removal of the drains to measure the levels of IL-6 and TNF-α. RESULTS: Both groups showed significant changes regarding peripheral blood CD3+, CD4+, and CD8+ T cell levels (p < 0.05). In the LVSS group, the level of CD16+56+ NK cells showed a significant decrease compared with the CT group (p < 0.05). The IL-6 and TNF-αlevels in the drainage fluid were significantly higher in the LVSS group. CONCLUSIONS: We demonstrated that LSJI can decrease operative time. Although the systemic inflammatory effect of LSJI remains inconclusive, the local inflammatory effect was significant, which could cause early and late postoperative problems.