Energy vessel sealant devices are associated with decreased risk of neck hematoma after thyroid surgery

Moran, Katherine; Grigorian, Areg; Elfenbein, Dawn M.; Schubl, Sebastian; Jutric, Zeljka; Lekawa, Michael; Nahmias, Jeffry

doi:10.1007/s13304-020-00776-9

Cited by 18 publications

(26 citation statements)

References 49 publications

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“…Compared to the non-EBD group, the EBD group had a significantly higher rate of hoarseness. However, the rate of severe hoarseness was significantly higher in the non-EBD group (1,8,9).…”

Section: Introductionmentioning

confidence: 78%

“…Thyroidectomy is one of the most common head and neck surgeries. In the United States, more than 150,000 thyroidectomies were performed annually, and the case number of thyroid surgery is increasing each year (1). Specific challenges of thyroid surgery include the complex vascularization of anatomy, the proximity of the operating field to the recurrent laryngeal nerve (RLN), and the need to preserve the parathyroid gland.…”

Section: Introductionmentioning

confidence: 99%

“…The "clamp-and-tie" technique was first introduced by Theodor Kocher in the 19th century. Since then, until the 1980s, clamp-and-tie, suture-ligation, electrocautery (monopolar or bipolar) and hemostatic clips have been widely adopted for hemostatic use in thyroid surgery (1,3,4). However, one of the most important technological advances in thyroid surgery occurred three decades ago: the introduction of energybased devices (EBDs).…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies indicate that EBDs are used in 65.7% of thyroidectomy patients (1). Reported intraoperative advantages of EBDs include considerably decreased operative time, incision length and blood loss.…”

Section: Introductionmentioning

confidence: 99%

“…Reported intraoperative advantages of EBDs include considerably decreased operative time, incision length and blood loss. Other clinically significant advantages of EBDs over conventional techniques include the superior postoperative outcomes of EBDs, e.g., reduced pain, wound drainage, neck hematoma, and hypocalcemia (1,2,5,6).…”

Section: Introductionmentioning

confidence: 99%

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Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

Wang

Huang

et al. 2021

Front. Endocrinol.

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Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time. However, the rate of recurrent laryngeal nerve (RLN) injury during EBD use has shown statistically inconsistent. EBDs generate high temperature that can cause iatrogenic thermal injury to the RLN by direct or indirect thermal spread. This article reviews relevant medical literatures of conventional electrocauteries and different mechanisms of current EBDs, and compares two safety parameters: safe distance and cooling time. In general, conventional electrocautery generates higher temperature and wider thermal spread range, but when applying EBDs near the RLN adequate activation distance and cooling time are still required to avoid inadvertent thermal injury. To improve voice outcomes in the quality-of-life era, surgeons should observe safety parameters and follow the standard procedures when using EBDs near the RLN in thyroid surgery

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“…Compared to the non-EBD group, the EBD group had a significantly higher rate of hoarseness. However, the rate of severe hoarseness was significantly higher in the non-EBD group (1,8,9).…”

Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

Wang

Huang

et al. 2021

Front. Endocrinol.

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Prevalence and Predictors of Post‐Thyroidectomy Voice Dysfunction in a Nigerian Cohort

et al. 2022

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Background Advances in surgical techniques have significantly improved the safety of thyroidectomy. Quality of life issues, such as voice changes, however continue to be important considerations. This study evaluated the prevalence and determinants of voice changes following thyroidectomies for non‐malignant goiters in a Nigerian Hospital. Methodology Consecutive adults who had thyroidectomy for non‐malignant goiters were evaluated. Preoperatively, each participant had laryngoscopy and voice assessment using the Voice Handicap Index‐10. At surgery, the intubation difficulty score, size of endotracheal tubes, and duration of operation were recorded. Laryngoscopy and VHI‐10 assessments were repeated 1 week, 1 month, and 3 months after surgery. Pre and postoperative assessments were compared. Result Fifty‐four patients completed the study. Subtotal thyroidectomy was the commonest operation performed in 17 patients (31.48%), with 14 (25.93%) having total thyroidectomy. Baseline median VHI‐10 score was 6.5(IQR‐10). Five patients had abnormal preoperative laryngoscopy findings (benign vocal cord lesions). Postoperatively, seven patients had endoscopic evidence of vocal cord paralysis, six were unilateral while one was bilateral. Ten patients (18.5%) had early voice changes. Median VHI‐10 score at one week was significantly higher than baseline (10 vs. 6.5, p = 0.01). At 3 months, VHI‐10 reverted back to baseline in five of the ten patients while five patients (9.3%) had persistent voice changes. Abnormal endoscopic findings predicted the occurrence of early postoperative voice changes. Conclusion Thyroidectomy for non‐malignant goiters is associated with transient voice changes, many of which revert to normal over time. Abnormal endoscopic findings predict its occurrence.

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Prévention et prise en charge de l’hématome cervical post thyroïdectomie. Recommandations de l’AFCE (Association francophone de chirurgie endocrinienne) avec la SFE (Société française d’endocrinologie) et la SFMN (Société française de médecine nucléaire)

Guérin

Heede²,

Deguelte³

et al. 2023

Journal de Chirurgie Viscérale

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Energy vessel sealant devices are associated with decreased risk of neck hematoma after thyroid surgery

Cited by 18 publications

References 49 publications

Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

Prevalence and Predictors of Post‐Thyroidectomy Voice Dysfunction in a Nigerian Cohort

Prévention et prise en charge de l’hématome cervical post thyroïdectomie. Recommandations de l’AFCE (Association francophone de chirurgie endocrinienne) avec la SFE (Société française d’endocrinologie) et la SFMN (Société française de médecine nucléaire)

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