Parathyroid function after open thyroidectomy: A prospective randomized study for ligasure precise versus harmonic FOCUS.

Dionigi, Gianlorenzo; Van Slycke, Sam; Rausei, Stefano; Boni, Luigi; Dionigi, Renzo

BACKGROUND Options for controlling hemostasis during thyroidectomy include bipolar vessel sealing system and ultrasonic technology. The purpose of this study was to compare these energy-based devices on the performance of open thyroidectomy for benign disease with emphasis given to postoperative parathyroid function. METHODS Among the available energy-based devices, the LigaSure Precise (LP; Valleylab, Boulder, CO) and FOCUS Shears (FS; Ethicon Endo-Surgery, Cincinnati, OH) were evaluated. One hundred ninety-nine consecutive patients scheduled for open thyroidectomy were prospectively randomized into 2 similar-sized groups. Operative time, morbidity, incision length, postoperative pain, and hospital stay were analyzed. Postoperative hypoparathyroidism was monitored with serial determinations of intact parathyroid hormone (iPTH) and serum calcium. RESULTS Early postoperative measurement of iPTH plasma level, although within the reference range, was significantly lower in the FS group (p < .001). Oral calcium supplementation was significantly higher and prolonged in the FS group. CONCLUSION The present study demonstrates a significant difference of the rates for postoperative parathyroid malfunction when using different energy-based devices.