“Comparing Hematoma Incidence Rates between Hemostatic Devices in Total Thyroidectomy: A Systematic Review and Meta-Analysis”
Nadia Hua, Alexandra Elizabeth Quimby, Stephanie Johnson-Obaseki
Objective: To compare the incidence of post-operative hematoma following thyroidectomy using Harmonic Scalpel© (HS) or Ligasure© (LS) versus conventional hemostatic (CH) techniques.
Method: A systematic literature search was performed for all relevant English language studies (1946–2018) using Ovid MEDLINE, EMBASE, PubMed, and CENTRAL. Two authors independently extracted data and analyzed articles to assess quality. Our primary outcome was post-operative hematoma requiring re-operation.
Results: A total of 348 studies were screened, with 33 studies meeting the inclusion criteria. The results of meta-analysis of RCTs and observational studies demonstrated no significant difference in post-operative hematoma rates between HS and CH (p=0.962), LS and CH (p=0.648), and HS and LS (p=0.957).
Conclusions: Hematoma incidence does not differ significantly with the use of HS and LS devices compared to CH during thyroidectomy. This information may help guide surgeons’ decisions regarding choice of hemostatic technique during thyroid surgery.
- Recognize the alternate energy devices that exist for use in thyroid surgery.
- Compare the post-operative outcomes of different hemostatic techniques used in thyroid surgery, including conventional hemostasis, Ligasure, and Harmonic Scalpel.
- Summarize the literature citing post-operative hematoma rates between conventional hemostasis and alternate energy devices in total thyroidectomy.
- Consider which hemostatic technique is most appropriate to use based on the surgeons’ personal practices.
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Authors' Contact Details
Corresponding Author: Ms. Nadia Hua (firstname.lastname@example.org)
Senior Author: Dr. Stephanie Johnson-Obaseki