Professional paper

Comparison of recurrent nerve injuries during thyroidectomy performed by conventional or harmonic scalpel

Stjepan Grabovac orcid.org/0000-0002-2190-7029 ; Bjelovar General Hospital, Department for Ear, Nose and Throat Diseases
Drago Prgomet ; Zagreb Clinical Hospital Center, Clinic of Otolaryngology and Head and Neck Surgery
Saša Janjanin ; Zagreb Clinical Hospital Center, Clinic of Otolaryngology and Head and Neck Surgery

Abstract

We have conducted a research to establish if there are any differences in recurrent laryngeal nerve injury between the patient groups who had thyroidectomy performed by a harmonic scalpel, and the control group, who had a conventional thyroidecotomy performed by cold instruments and the primary hemostasis by
ligation and electrocoagulation. Both groups included randomised patients who were operated due to standard indications for thyroid gland surgery. The first group included 123 patients; 63 with lobectomy and 60 with total thyroidectomy. The second group had 106 thyroidectomies performed; 60 lobectomies and 46
total thyroidectomies. Pre-surgery and post-surgery mobility of vocal cords in both groups of patients was established by fiberoptic laryngoscopy. During the surgery, while activating the harmonic scalpel and monopolar and bipolar electro-instruments in the vicinity of the recurrent laryngeal nerve, basic electrical activity of glottic musculature was observed by the intra-operative electro-monitoring system.
The statistical analysis of results proved that thyroidectomies performed by the harmonic scalpel are as safe as the conventional methods of thyroidecotmy, i.e. that the application of the harmonic scalpel does not lead to a statistically more significant recurrence of permanent pareses of the recurrent laryngeal nerve in relation to surgeries with haemostasis by ligatures and electrocoagulation.

Keywords

electromonitoring; recurrent nerve; thyroid gland; thyroidectomy; harmonic scalpel

Hrčak ID:

107251

URI

https://hrcak.srce.hr/107251

Publication date:

11.9.2013.

Article data in other languages: croatian

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