Óscar Vidal-Pérez1, Luis Flores-Siguenza2, Mauro Valentini2, Emiliano Astudillo-Pombo2, Laureano Fernández-Cruz2, Juan Carlos García-Valdecasas2. 1. Unidad de Cirugía General y Endocrina, Departamento de Cirugía General y Digestiva, Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic y Provincial de Barcelona, Universidad de Barcelona, CIRBERHED, IDIBAPS, Barcelona, España. Electronic address: ovidal@clinic.ub.es. 2. Unidad de Cirugía General y Endocrina, Departamento de Cirugía General y Digestiva, Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic y Provincial de Barcelona, Universidad de Barcelona, CIRBERHED, IDIBAPS, Barcelona, España.
Abstract
BACKGROUND: In recent years, several publications have shown that new adhesives and sealants, like Tissucol(®), applied in thyroid space reduce local complications after thyroidectomies. STUDY AIMS: To demonstrate the effectiveness of fibrin glue Tissucol(®) in reducing the post-operative hospital stay of patients operated on for differentiated thyroid carcinoma in which total thyroidectomy with central and unilateral node neck dissection was performed (due to the debit drains decrease), with consequent cost savings. MATERIAL AND METHODS: A prospective randomised study was conducted during the period between May 2009 and October 2013 on patients with differentiated thyroid carcinoma with cervical nodal metastases, and subjected to elective surgery. Two groups were formed: one in which Tissucol(®) was used (case group) and another where it was not used (control group). Patients were operated on by surgeons specifically dedicated to endocrine surgical pathology, using the same surgical technique in all cases. RESULTS: A total of 60 total thyroidectomies with lymph node dissection were performed, with 30 patients in the case group, and 30 patients in control group. No statistically significant differences were observed in most of the studied variables. However, the case group had a shorter hospital stay than the control group with a statistically significant difference (p<0.05). CONCLUSION: Implementation of Tissucol(®) has statistically and significantly reduced the hospital stay of patients undergoing total thyroidectomy with neck dissection, which represents a significant reduction in hospital costs. This decrease in hospital stay has no influence on the occurrence of major complications related to the intervention.
RCT Entities:
BACKGROUND: In recent years, several publications have shown that new adhesives and sealants, like Tissucol(®), applied in thyroid space reduce local complications after thyroidectomies. STUDY AIMS: To demonstrate the effectiveness of fibrin glue Tissucol(®) in reducing the post-operative hospital stay of patients operated on for differentiated thyroid carcinoma in which total thyroidectomy with central and unilateral node neck dissection was performed (due to the debit drains decrease), with consequent cost savings. MATERIAL AND METHODS: A prospective randomised study was conducted during the period between May 2009 and October 2013 on patients with differentiated thyroid carcinoma with cervical nodal metastases, and subjected to elective surgery. Two groups were formed: one in which Tissucol(®) was used (case group) and another where it was not used (control group). Patients were operated on by surgeons specifically dedicated to endocrine surgical pathology, using the same surgical technique in all cases. RESULTS: A total of 60 total thyroidectomies with lymph node dissection were performed, with 30 patients in the case group, and 30 patients in control group. No statistically significant differences were observed in most of the studied variables. However, the case group had a shorter hospital stay than the control group with a statistically significant difference (p<0.05). CONCLUSION: Implementation of Tissucol(®) has statistically and significantly reduced the hospital stay of patients undergoing total thyroidectomy with neck dissection, which represents a significant reduction in hospital costs. This decrease in hospital stay has no influence on the occurrence of major complications related to the intervention.
Authors: Mandeep S Bajwa; Stacey Carruthers; Rob Hanson; Richard Jackson; Chris Braithwaite; Mike Edwards; Seema Chauhan; Catrin Tudur Smith; Richard J Shaw; Andrew G Schache Journal: Pilot Feasibility Stud Date: 2020-05-26