Aim
To compare ultrasonic dissector with conventional methods (suture ligation/ electrocautery) in achieving haemostasis in thyroid surgery.
Method
43 cases of thyroid disease underwent thyroidectomy by open method in the Department of Surgery PGIMER & DR RML HOSPITAL, New Delhi. Patients who met the inclusion and exclusion criteria were allocated to either group A (Ultrasonic dissector group), or group B (conventional haemostasis group), by simple random technique through opaque closed envelope method.
Results
Mean duration of surgery was significantly lower in group A subjects (113.2 minutes), as compared to the Group B subjects (140.9 minutes). Group A subjects (6.9 mops) have significantly lesser mean intra operative bleeding than Group B subjects (8.5 mops) (p-value = 0.007). There was a significant decrease in total drainage output in group A subjects (98.1 ml), as compared to Group B subjects (123.5 ml) (p-value <0.001), and a significant reduction in time for which drainage tube was kept in group A subjects (3.7 days), as compared to group B (4.4 days) (p-value = 0.007). There was significant reduction in hospital stay in subjects of group A (4.6 days), as compared to group B subjects (5.8 days) (p-value <0.001). Mann Whitney U analysis reveals that there was no statistical significant difference between post-operative pain in the subjects of two groups (P- value =0.496).
Conclusion
The present study shows that, the ultrasonic dissector reduces the operative time, intra operative blood loss, postoperative drainage and length of hospital stay with normal post op serum calcium levels and intact RLN. Therefore, we conclude that the Ultrasonic dissector is as safe and effective tool as a conventional method for haemostasis in thyroid surgery.