Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery

Ryu Han Byul; Ahn Jong-hyuk; Kim Jae Hwan; Choi Seong Woon; Choi Yun Suk; Yi Jin Wook

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자료유형: 학술저널

저자정보: Ryu Han Byul (Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.) Ahn Jong-hyuk (Department of Surgery Seoul National University Hospital Seoul National University College of Medic) Kim Jae Hwan (Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.) Choi Seong Woon (Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.) Choi Yun Suk (Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.) Yi Jin Wook (Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.)

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제20권 제4호

발행연도: 2020.1

수록면: 69 - 77 (9page)

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Purpose: The bilateral axillary breast approach (BABA) is frequently utilized for remote access thyroid surgery. The first step in this surgical approach is to make a subcutaneous flap from the axilla to the neck, usually using a Harmonic ACE. Our institution has utilized LigaSure to create these flaps. This study reports comparative results with these 2 energy devices. Methods: Medical data and video clips from 73 patients who underwent robotic BABA thyroid surgery were retrospectively reviewed. Flaps for BABA were created by first and second year endocrine fellows under the guidance of an experienced endocrine surgeon. There were no criteria for allocation to energy devices. Results: Of the 73 patients, 31 and 42 underwent flap creation with the Harmonic ACE and LigaSure devices, respectively. Demographic characteristics were similar in the 2 groups. Mean time for flap creation was significantly shorter (33.46±8.33 vs. 38.27±7.14 min, P=0.012), and mean number of camera cleanings significantly lower (4.21±2.53 vs. 10.45±4.95, P<0.001), in the LigaSure group. Surgical site pain on day 2 was significantly lower in the LigaSure group. Postoperative bleeding and skin burn occurred only in patients in the Harmonic group. Conclusion: LigaSure showed better performance than the Harmonic ACE device for BABA flap creation, as shown by time for flap creation, postoperative pain scores, and complications. Because this study was a small sized retrospective comparison, large randomized controlled trials are needed to confirm these results.

#Thyroid neoplasms #Robotic surgical procedures #Surgical flap #Electrosurgery

참고문헌 (24)

참고문헌 신청

정규원 / 2019 / Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2016 / Cancer Research and Treatment 51(2):417~430

Choe JH / 2007 / Endoscopic thyroidectomy using a new bilateral axillo-breast approach / World J Surg 31:601~606

Lee KE / 2009 / Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach(BABA)technique : our initial experience / Surg Laparosc Endosc Percutan Tech 19:e71~e75

태경 / 2019 / Robotic and Endoscopic Thyroid Surgery: Evolution and Advances / Clinical and Experimental Otorhinolaryngology 12(1):1~11

Lee KE / 2010 / Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach / Surgery 148:1207~1213

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이 논문의 저자 정보

Ryu Han Byul

소속기관 Department of Surgery Inha University Hospital Inha University College of Medicine Incheon Korea.