During the last 6 months of 1991 we operated on 250 patients for thyroid diseases; among them, 116were studied to evaluate the effects of a fibrin sealant (Tissucol, Immuno) in thyroid surgery. We analyzed our data with regard to the technique performed (total lobectomy, subtotal thyroidectomy, or total thyroidectomy), without considering basic illness. Patients treated with fibrin glue (n = 51) formed group 1. Untreated patients (n = 65) formed group 2. Quantitative Analysis Total Thyroidectomy (global data: group 1 (n = 28) mean = 82.39 cc (sd = 37.39). Group 2 (n = 29) mean = 121.79 cc (sd = 44.36). Single days: group 1: 72.18 cc (first day), 10.21 cc (second day). Group 2: 94.41 and 29.18 cc respectively. The difference between the groups is statistically significant (p < .05). The effect was observed using 1, 2 and 5 cc of Tissucol. Subtotal Thyroidectomy (global data: group 1 (n = 15) mean = 75.8 cc (sd = 26.62). Group 2 (n = 17) mean = 160.59 cc (sd = 65.52). Single days: group 1: 69.72 cc (first day), 6.53 cc (second day). Group 2: 120.29 and 40.29 cc, respectively. The difference between the groups is statistically significant (p < .05). We observed the effect using 2, 2.5 and 5 cc of Tissucol. Total Lobectomy (global data: (n = 8) mean = 51.25 cc (sd = 21.17). Group 2 (n = 19) mean = 86.32 cc (sd = 38.36). Single days: group 1: 45.87 cc (first day), 5.38 cc (second day). Group 2: 67.89 and 18.42 cc, respectively. The difference between the groups is statistically significant (p < .05). We observed the effect both using 1 and 2 cc of Tissucol. Qualitative Analysis - Hematocrit: A difference has been observed between the first and second postoperative days: group 1from 8.8 % to 2 %; group 2 from 9.8 % to 6.9 %. - Red blood cells: We observed a similar trend: group] from 839270 to 210000 RBC/mm3 ; group 2 from 1060740 to 551000. _ White blood cells: Group 1 from 8183 to 2063 WBC/mm3 ; group 2 from 7168 to 10603. _ Percentage of leukocytes: No differences were observed between the groups. _ Platelets: In the first day we had a mean of 85000 in group 1 (sd = 24260) and of 129000 in the group 2 (sd = 23490). Conclusions The use of fibrin sealant (Tissucol, Immuno, Vienna) reduces surgical field bleeding in thyroid surgery, regardless of the surgical technique performed. The best results are obtained in subtotal thyroidectomy, a technique that, among those employed, leaves the largest bleeding surface; the results are scarcely influenced by basic illness. It permits a shortening of the postoperative period of hospitalization. The presence of fibrin glue determines a difference in the quality of secretion, too, indirectly reflecting its various effects on surgical wound.
Effects of fibrin sealant in throid surgery
PUCCINI, MARCO;IACCONI, PIETRO;MICCOLI, PAOLO
1994-01-01
Abstract
During the last 6 months of 1991 we operated on 250 patients for thyroid diseases; among them, 116were studied to evaluate the effects of a fibrin sealant (Tissucol, Immuno) in thyroid surgery. We analyzed our data with regard to the technique performed (total lobectomy, subtotal thyroidectomy, or total thyroidectomy), without considering basic illness. Patients treated with fibrin glue (n = 51) formed group 1. Untreated patients (n = 65) formed group 2. Quantitative Analysis Total Thyroidectomy (global data: group 1 (n = 28) mean = 82.39 cc (sd = 37.39). Group 2 (n = 29) mean = 121.79 cc (sd = 44.36). Single days: group 1: 72.18 cc (first day), 10.21 cc (second day). Group 2: 94.41 and 29.18 cc respectively. The difference between the groups is statistically significant (p < .05). The effect was observed using 1, 2 and 5 cc of Tissucol. Subtotal Thyroidectomy (global data: group 1 (n = 15) mean = 75.8 cc (sd = 26.62). Group 2 (n = 17) mean = 160.59 cc (sd = 65.52). Single days: group 1: 69.72 cc (first day), 6.53 cc (second day). Group 2: 120.29 and 40.29 cc, respectively. The difference between the groups is statistically significant (p < .05). We observed the effect using 2, 2.5 and 5 cc of Tissucol. Total Lobectomy (global data: (n = 8) mean = 51.25 cc (sd = 21.17). Group 2 (n = 19) mean = 86.32 cc (sd = 38.36). Single days: group 1: 45.87 cc (first day), 5.38 cc (second day). Group 2: 67.89 and 18.42 cc, respectively. The difference between the groups is statistically significant (p < .05). We observed the effect both using 1 and 2 cc of Tissucol. Qualitative Analysis - Hematocrit: A difference has been observed between the first and second postoperative days: group 1from 8.8 % to 2 %; group 2 from 9.8 % to 6.9 %. - Red blood cells: We observed a similar trend: group] from 839270 to 210000 RBC/mm3 ; group 2 from 1060740 to 551000. _ White blood cells: Group 1 from 8183 to 2063 WBC/mm3 ; group 2 from 7168 to 10603. _ Percentage of leukocytes: No differences were observed between the groups. _ Platelets: In the first day we had a mean of 85000 in group 1 (sd = 24260) and of 129000 in the group 2 (sd = 23490). Conclusions The use of fibrin sealant (Tissucol, Immuno, Vienna) reduces surgical field bleeding in thyroid surgery, regardless of the surgical technique performed. The best results are obtained in subtotal thyroidectomy, a technique that, among those employed, leaves the largest bleeding surface; the results are scarcely influenced by basic illness. It permits a shortening of the postoperative period of hospitalization. The presence of fibrin glue determines a difference in the quality of secretion, too, indirectly reflecting its various effects on surgical wound.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
