Ligasure versus ultracision in thyroid surgery: a prospective randomized study.

Purpose: New hemostatic technologies (NT) are often employed in thyroid surgery in the effort to reduce operating time and complications. The aim of this study is to compare three different hemostatic techniques. Methods: This is a prospective randomized study. There were 150 patients, aged 56±14 years, randomized for total thyroidectomy with conventional technique (CT), Ligasure vessel sealing system (LI) or Harmonic Scalpel (HS) at the university surgical department. One hundred thirty-five patients had benign diseases; 15 had malignancies. Results: Mean postoperative hospital stay was 2.6 days. Mean operation time was 113±31 min; in HS patients, it was significantly shorter (p<0.001). Morbidity was 43.3%; mortality was nil. Morbidity was significantly different between CT and NT groups (p=0.0002); HS and LI groups had a higher morbidity (p=0.0001 and p=0.02, respectively). Mean postoperative calcemia was 1.12±0.1 mmol/l with a significant difference between groups; NT patients had a significantly lower calcemia (p<0.05). There was no difference in recurrent laryngeal nerve palsies and in intraoperative blood losses (p=ns). Conclusions: According to our experience, the only real advantage of new hemostatic technologies was a shorter operation time with HS. © 2008 Springer-Verlag.