Intraoperative and Postoperative Blood Loss in Subtotal Thyroidectomy Using Ligasure versus Conventional Thread Knot and Cautery

Abstract

Background: Thyroidectomy is a common procedure performed & thyroid gland being highly vascular, its surgery results in lot of bleeding. New energy devices like, ligasure are being commonly used nowadays in thyroid surgery to reduce per-operative bleeding. Objective: To compare intraoperative and postoperative blood loss in subtotal thyroidectomy using small jaw Ligasure versus conventional vessel knotting and Cautery. Study Design: Randomized controlled trial. Settings: Department of General Surgery, Allied Hospital, Faisalabad Pakistan. Duration: Six months from 11-09-2020 to 10-03-2021. Methods: Total 160 patients 80 in each group) with benign multinodular goiter were included in the study. Patients having thyroid malignancy, recurrent goiter requiring redo surgery and coagulopathies were excluded. Group A patients underwent subtotal thyroidectomy with conventional thread vessel knotting and Cautery and group B patients were operated with Ligasure small jaw device. Intraoperative and postoperative blood loss of all patients was measured and documented. Data was analyzed by SPSS 23.0. A p-value ≤0.05 was taken as significant. Results: Mean intra-operative blood loss was calculated as 116 ± 4ml in group-A and 59 ± 4ml in group-B and (p=0.001). The mean post-operative blood loss was calculated to be 81 ± 3ml in group-A and 53 ± 3ml in group-B (p=0.001). Conclusion: Subtotal thyroidectomy in benign multinodular goiters with Ligasure small jaw device has significantly less blood loss both intraoperative and postoperatively as compared to conventional Cautery and thread vessel knotting.