Clinical Application of Bipolar Coagulation Forceps in Open Thyroid Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Department of General Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China;

Corresponding?author：

Keywords：

Bipolar coagulation forceps; Harmonic scalpel; Thyroid; Operation

DOI：

10.7507/1007-9424.20160019

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Objective To explore the feasibility and safety of clinical application of bipolar coagulation forceps in open thyroid operations and summarize the operation skill. Methods The clinical data of 347 cases performed thyroid operations with bipolar coagulation forceps and Harmonic scalpel respectively from October 2010 to October 2014 in our hospital were analyzed retrospectively. Results No statistical differences was found on the operative time, intraoperative bleeding, postoperative drainage, and postoperative hospitalization of the two groups (P > 0.05). The complications of transient palsy of recurrent laryngeal nerve and transient functional insufficiency of parathyroid were more in Harmonic scalpel group than in bipolar coagulation forceps group with statistical difference (P < 0.05). But there was no difference of the complications of airway obstruction, permanent injuries of recurrent laryngeal nerve, parathyroid and superior laryngeal nerve in the two groups (P > 0.05). Conclusions Thyroid operations with bipolar coagulation forceps are safe and feasible. Coagulation tightly along the thyroid capsule followed by incision with explicit subtle dissection is the key point of the decrease of complications.

Citation： LIJia-yong, SANGJian-feng, YAOYong-zhong, WANGXue-chen, SULei. Clinical Application of Bipolar Coagulation Forceps in Open Thyroid Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(1): 75-78. doi: 10.7507/1007-9424.20160019 Copy

1.	錢碧云, 何敏, 高明, 等. 2002-2006年天津市甲狀腺癌發病率與26年間長期趨勢分析.中華普通外科雜志, 2011, 26(4):275-278.
2.	Dhepnorrarat RC, Witterick IJ. New technologies in thyroid cancer surgery. Oral Oncol, 2013, 49(7):659-664.
3.	Grant CS. Recurrence of papillary thyroid cancer after optimized surgery. Gland Surg, 2015, 4(1):52-62.
4.	Yen WY, Qiu W. The feasibility of total or near-total bilateral thyroi-dectomy for the treatment of bilateral multinodular goiter. J Invest Surg, 2009, 22(3):195-200.
5.	蘇磊, 桑劍鋒, 姚永忠, 等.甲狀腺全切除治療原發性甲狀腺功能亢進癥合并甲狀腺癌24例.實用醫學雜志, 2012, 28(4):616-617.
6.	魏濤, 朱精強.甲狀腺手術理念進展與新型手術器械在甲狀腺外科的應用.中國普外基礎與臨床雜志, 2011, 18(2):220-224.
7.	Alhan E1, Usta A, Türky?lmaz S. Total thyroidectomy for manage-ment of benign multinodular goitre in an endemic region:review of 620 cases. Acta Chir Belg, 2005, 115(3):198-201.
8.	Lorente-Poch L, Sancho JJ, Ruiz S, et al. Importance of in situ preser-vation of parathyroid glands during total thyroidectomy. Br J Surg, 2015, 102(4):359-367.
9.	盧春燕, 李志輝, 朱精強, 等.術后甲狀旁腺機能減退癥的診斷及處理.中國普外基礎與臨床雜志, 2014, 21(4):501-506.
10.	Hwang SO, Jung JH, Park HY, et al. A prospective, randomized study between the small jaw^? and the Harmonic Focus^? in open thyroidectomy. Otolaryngol Head Neck Surg, 2014, 150(6):943-948.
11.	Teksoz S, Bukey Y, Ozcan M, et al. Sutureless thyroidectomy with energy-based devices:Cerrahpasa experience. Updates Surg, 2013, 65(4):301-307.
12.	Konturek A, Barczynski M, Stopa M, et al. Total thyroidectomy for non-toxic multinodular goiter with versus without the ues of harmonic FOCUS dissecting shears-a prospective randomized study. Wideochir Inne Maloinwazyine, 2012, 7(4):268-274.
13.	朱永軍, 楊見明, 許海艷, 等. 94例甲狀腺手術中超聲刀的應用.齊齊哈爾醫學院學報, 2012, 33(19):2617-2618.
14.	Yildirim O, Umit T, Ebru M, et al. Ultrasonic harmonic scalpel in total thyroidectomies. Adv Ther, 2008, 25(3):260-265.
15.	Kwak HY, Chae BJ, Park YG, et al. Comparison of surgical outcomes between papillary thyroid cancer patients treated with the Harmonic ACE scalpel and LigaSure Precise instrument during conventional thyroidectomy:a single-blind prospective randomized control trial. J Surg Res, 2014, 187(2):484-489.
16.	江道振, 仇明, 張軍初, 等.經胸前徑路內鏡甲狀腺切除術與常規入路的比較研究.中華普通外科雜志, 2010, 19(8):486-487.
17.	Zanghi A, Cavaliaro A, Di Vita.M et al. The safety of the Harmonic^? Focus in open thyroidectomy:a prospective, randomized study comparing the Harmonic^? Focus and traditional suture ligation (knot and tie) technique. Int J Surg, 2014, 12 Suppl 1:S132-S135.
18.	魏濤, 張明, 李潔清, 等.超聲刀結合雙極電凝鑷與超聲刀結合傳統結扎方法在開放甲狀腺手術中的引用-隨機對照研究.中國普外基礎與臨床雜志, 2012, 19(2):157-164.
19.	沈宏亮, 仇明.超聲刀在甲狀腺手術中的應用.中國醫療器械信息, 2009, 15(11):6-7.
20.	Ciftci F, Sakalli E, Abdurrahman I, et al. Parathyroid function following total thyroidectomy using energy devices. Eur Arch Otorhinolaryngol, 2015, Jul 4.[Epub ahead of print].
21.	Elliott-Lewis EW, Mason AM, Barrow DL. Evaluation of a new bipolar coagulation forceps in a thermal damage assessment. Neurosurgery, 2009, 65(6):1182-1187.
22.	Guo JY, Li DW, Liao R, et al. Outcomes of simple saline-coupled bioplar electrocautery for hepatic resection. World J Gastroenterol, 2014, 20(26):8638-8645.
23.	Hefermehl LJ, Largo RA, Hermanns T, et al. Lateral temperature spread of monopolar, bipolar and ultrasonic instruments for robot-assisted laparoscopic surgery. BJU Int, 2014, 114(2):245-252.
24.	周龍翔, 俞冬, 徐軍, 等.采用精細化被膜解剖+喉返神經顯露法行甲狀腺腺葉切除452例臨床分析.中國普外基礎與臨床雜志, 2013, 20(6):638-642.
25.	Walen SG, Rudmik LR, Dixon E, et al. The utility of the harmonic scalpel in selective neck dissection:a prospective, randomized trial. Otolaryngol Head Neck Surg, 2011, 144(6):894-899.

1. 錢碧云, 何敏, 高明, 等. 2002-2006年天津市甲狀腺癌發病率與26年間長期趨勢分析.中華普通外科雜志, 2011, 26(4):275-278.
2. Dhepnorrarat RC, Witterick IJ. New technologies in thyroid cancer surgery. Oral Oncol, 2013, 49(7):659-664.
3. Grant CS. Recurrence of papillary thyroid cancer after optimized surgery. Gland Surg, 2015, 4(1):52-62.
4. Yen WY, Qiu W. The feasibility of total or near-total bilateral thyroi-dectomy for the treatment of bilateral multinodular goiter. J Invest Surg, 2009, 22(3):195-200.
5. 蘇磊, 桑劍鋒, 姚永忠, 等.甲狀腺全切除治療原發性甲狀腺功能亢進癥合并甲狀腺癌24例.實用醫學雜志, 2012, 28(4):616-617.
6. 魏濤, 朱精強.甲狀腺手術理念進展與新型手術器械在甲狀腺外科的應用.中國普外基礎與臨床雜志, 2011, 18(2):220-224.
7. Alhan E1, Usta A, Türky?lmaz S. Total thyroidectomy for manage-ment of benign multinodular goitre in an endemic region:review of 620 cases. Acta Chir Belg, 2005, 115(3):198-201.
8. Lorente-Poch L, Sancho JJ, Ruiz S, et al. Importance of in situ preser-vation of parathyroid glands during total thyroidectomy. Br J Surg, 2015, 102(4):359-367.
9. 盧春燕, 李志輝, 朱精強, 等.術后甲狀旁腺機能減退癥的診斷及處理.中國普外基礎與臨床雜志, 2014, 21(4):501-506.
10. Hwang SO, Jung JH, Park HY, et al. A prospective, randomized study between the small jaw^? and the Harmonic Focus^? in open thyroidectomy. Otolaryngol Head Neck Surg, 2014, 150(6):943-948.
11. Teksoz S, Bukey Y, Ozcan M, et al. Sutureless thyroidectomy with energy-based devices:Cerrahpasa experience. Updates Surg, 2013, 65(4):301-307.
12. Konturek A, Barczynski M, Stopa M, et al. Total thyroidectomy for non-toxic multinodular goiter with versus without the ues of harmonic FOCUS dissecting shears-a prospective randomized study. Wideochir Inne Maloinwazyine, 2012, 7(4):268-274.
13. 朱永軍, 楊見明, 許海艷, 等. 94例甲狀腺手術中超聲刀的應用.齊齊哈爾醫學院學報, 2012, 33(19):2617-2618.
14. Yildirim O, Umit T, Ebru M, et al. Ultrasonic harmonic scalpel in total thyroidectomies. Adv Ther, 2008, 25(3):260-265.
15. Kwak HY, Chae BJ, Park YG, et al. Comparison of surgical outcomes between papillary thyroid cancer patients treated with the Harmonic ACE scalpel and LigaSure Precise instrument during conventional thyroidectomy:a single-blind prospective randomized control trial. J Surg Res, 2014, 187(2):484-489.
16. 江道振, 仇明, 張軍初, 等.經胸前徑路內鏡甲狀腺切除術與常規入路的比較研究.中華普通外科雜志, 2010, 19(8):486-487.
17. Zanghi A, Cavaliaro A, Di Vita.M et al. The safety of the Harmonic^? Focus in open thyroidectomy:a prospective, randomized study comparing the Harmonic^? Focus and traditional suture ligation (knot and tie) technique. Int J Surg, 2014, 12 Suppl 1:S132-S135.
18. 魏濤, 張明, 李潔清, 等.超聲刀結合雙極電凝鑷與超聲刀結合傳統結扎方法在開放甲狀腺手術中的引用-隨機對照研究.中國普外基礎與臨床雜志, 2012, 19(2):157-164.
19. 沈宏亮, 仇明.超聲刀在甲狀腺手術中的應用.中國醫療器械信息, 2009, 15(11):6-7.
20. Ciftci F, Sakalli E, Abdurrahman I, et al. Parathyroid function following total thyroidectomy using energy devices. Eur Arch Otorhinolaryngol, 2015, Jul 4.[Epub ahead of print].
21. Elliott-Lewis EW, Mason AM, Barrow DL. Evaluation of a new bipolar coagulation forceps in a thermal damage assessment. Neurosurgery, 2009, 65(6):1182-1187.
22. Guo JY, Li DW, Liao R, et al. Outcomes of simple saline-coupled bioplar electrocautery for hepatic resection. World J Gastroenterol, 2014, 20(26):8638-8645.
23. Hefermehl LJ, Largo RA, Hermanns T, et al. Lateral temperature spread of monopolar, bipolar and ultrasonic instruments for robot-assisted laparoscopic surgery. BJU Int, 2014, 114(2):245-252.
24. 周龍翔, 俞冬, 徐軍, 等.采用精細化被膜解剖+喉返神經顯露法行甲狀腺腺葉切除452例臨床分析.中國普外基礎與臨床雜志, 2013, 20(6):638-642.
25. Walen SG, Rudmik LR, Dixon E, et al. The utility of the harmonic scalpel in selective neck dissection:a prospective, randomized trial. Otolaryngol Head Neck Surg, 2011, 144(6):894-899.

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