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Analysis and Comparison of Ultrasonic-Shears-Assisted Thyroidectomy versus Conventional Clamp-And-Tie Thyroidectomy
Heather A Ford, David M Brams, John P Wei
Lahey Clinic, Burlington, MA
Objective: Conventional thyroid surgery using clamps and ties has been the standard method of operation for many years. The introduction of the ultrasonic shears to the operating room has allowed a changed in the technique of thyroid surgery and may provide improvements to the operation. We compared our experience with a standard clamp-and-tie (CAT) thyroidectomy versus ultrasonic-shears-assisted (USA) thyroidectomy to identify any advantage with the introduction of this new technology.
Design: retrospective comparison of clinical records
Setting: academic tertiary teaching hospital
Patients: 122 patients undergoing thyroid surgery from January 2005 to January 2007
Interventions: clamp-and-tie versus ultrasonic-shears thyroid surgery
Main Outcome Measures: length in time of surgery and time in operating room.
Results: There were 122 thyroid operations in 92 females and 30 males, with a mean age of 54 years. 59 total and 63 hemi thyroidectomies were performed, in which 69 were CAT and 53 were USA procedures. The mean operative time for CAT (N=42) vs USA (N=21) hemi-thyroidectomy was 94 vs 75 min, p<0.05. The mean operative time for CAT (N=27) vs USA (N=32) total thyroidectomy was 127 vs 95 min, p<0.05. The mean total operating room time for CAT vs USA hemi-thyroidectomy was 138 vs 113 min, p<0.05, and the mean total operating room time for CAT vs USA total thyroidectomy was 167 vs 132 min, p<0.05.
Conclusions: The use of ultrasonic-shears-assisted thyroidectomy has a significant savings in operative time compared to standard clamp-and tie thyroidectomy. Allowing for other variables in the operating room, there was still a savings in total operating room time with the use of the ultrasonic shears for thyroid operations.
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