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.	钱碧云, 何敏, 高明, 等. 2002-2006年天津市甲状腺癌发病率与26年间长期趋势分析.中华普通外科杂志, 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.	苏磊, 桑剑锋, 姚永忠, 等.甲状腺全切除治疗原发性甲状腺功能亢进症合并甲状腺癌24例.实用医学杂志, 2012, 28(4):616-617.
6.	魏涛, 朱精强.甲状腺手术理念进展与新型手术器械在甲状腺外科的应用.中国普外基础与临床杂志, 2011, 18(2):220-224.
7.	Alhan E1, Usta A, Türkyılmaz 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.	卢春燕, 李志辉, 朱精强, 等.术后甲状旁腺机能减退症的诊断及处理.中国普外基础与临床杂志, 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.	朱永军, 杨见明, 许海艳, 等. 94例甲状腺手术中超声刀的应用.齐齐哈尔医学院学报, 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, 张军初, 等.经胸前径路内镜甲状腺切除术与常规入路的比较研究.中华普通外科杂志, 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.	魏涛, 张明, 李洁清, 等.超声刀结合双极电凝镊与超声刀结合传统结扎方法在开放甲状腺手术中的引用-随机对照研究.中国普外基础与临床杂志, 2012, 19(2):157-164.
19.	沈宏亮, 仇明.超声刀在甲状腺手术中的应用.中国医疗器械信息, 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.	周龙翔, 俞冬, 徐军, 等.采用精细化被膜解剖+喉返神经显露法行甲状腺腺叶切除452例临床分析.中国普外基础与临床杂志, 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. 钱碧云, 何敏, 高明, 等. 2002-2006年天津市甲状腺癌发病率与26年间长期趋势分析.中华普通外科杂志, 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. 苏磊, 桑剑锋, 姚永忠, 等.甲状腺全切除治疗原发性甲状腺功能亢进症合并甲状腺癌24例.实用医学杂志, 2012, 28(4):616-617.
6. 魏涛, 朱精强.甲状腺手术理念进展与新型手术器械在甲状腺外科的应用.中国普外基础与临床杂志, 2011, 18(2):220-224.
7. Alhan E1, Usta A, Türkyılmaz 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. 卢春燕, 李志辉, 朱精强, 等.术后甲状旁腺机能减退症的诊断及处理.中国普外基础与临床杂志, 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. 朱永军, 杨见明, 许海艳, 等. 94例甲状腺手术中超声刀的应用.齐齐哈尔医学院学报, 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, 张军初, 等.经胸前径路内镜甲状腺切除术与常规入路的比较研究.中华普通外科杂志, 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. 魏涛, 张明, 李洁清, 等.超声刀结合双极电凝镊与超声刀结合传统结扎方法在开放甲状腺手术中的引用-随机对照研究.中国普外基础与临床杂志, 2012, 19(2):157-164.
19. 沈宏亮, 仇明.超声刀在甲状腺手术中的应用.中国医疗器械信息, 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. 周龙翔, 俞冬, 徐军, 等.采用精细化被膜解剖+喉返神经显露法行甲状腺腺叶切除452例临床分析.中国普外基础与临床杂志, 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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