HARMONIC SCALPEL POSSIBILITIES IN THE SURGICAL TREATMENT OF SECONDARY HYPERPARATHYROIDISM
Journal Title: Journal of IMAB - Annual Proceeding (Scientific Papers) - Year 2013, Vol 19, Issue 1
Abstract
The significant changes in coagulation status during chroniodialysis, performed in patients with secondary hyperparathyroidism require completion of meticulous surgical hemostasis in order to prevent active bleeding in the postoperative period. Aim: To present our experience with harmonic scalpel application in the surgical treatment of secondary hyperparathyroidism. Patients and Methods: 112 patients with secondary hyperparathyroidism (77 males and 35 females, aged from 23 to 60 years) have been operated on in our institution for 10 years period. All patients were on chroniodialysis. Hemostasis was achieved using conventional instruments and electrocautery in 46 patients and in 66 patients harmonic scalpel of Ethicon EndoSurgeryCare has been used. All patients had serum levels of parathormone above 2500ng/l. Ultrasonic examination revealed at least 2 parathyroid glands larger than 10mm in all cases. The amount of blood loss, necessity and type of drainages used, frequency of postoperative complications, postoperative hospital stay were comparatively evaluated. Results: In 12 patients parathyroidectomy with autotransplantation was carried out, in 62 patients subtotal parathyroidectomy was performed. In the rest 35 cases- three of the parathyroid glands were removed (because of the impossibility to identify the fourth parathyroid gland, using ultrasonic and intraoperative methods). All patients were proven to have a sharp decrease in parathormone and Calcium serum levels. In the group of patients, where conventional instruments and electrocautery for hemostasis have been used, corrugated and tube drainages were applied as a rule. For the patients, in whom hemostasis was performed using a harmonic scalpel, simple glove drainages were used. In all patients in the pre-operative and post-operative period serial hemodialysis was done with LMW heparin administration. Significantly lower blood loss from the surgical wound was found in the group, where harmonic scission was used. Conclusions: We consider that the application of harmonic scalpel in the surgical treatment of patients with secondary hyperparathyroidism on chroniodialysis leads to safer hemostasis, lower postoperative complications rate and thus shortens the postoperative hospital stay.
Authors and Affiliations
Rumen Nenkov, Radoslav Radev, Ekaterina Marinova, Nikolay Cvetkov, Anatoli Semkov, Borislav Petrov
Keywords
Related Articles
- EP ID EP93764
- DOI 10.5272/jimab.2013191.412
- Views 120
- Downloads 0
REDUCTION OF MOBILITY OF PERIODONTALY AFFECTED TEETH AFTER GINGIVAL AUGMENTATION WITH AN AUTOGENOUS GINGIVAL GRAFT (Case Report).
INTRODUCTION: The most severe complication of advanced periodontal lesions is the loss of teeth due to terminal attachment loss and high grade mobility. The goals of the treatment are the improving the plaque control sta...
TRANSMISSION OF Porphyromonas gingivalis FROM CAREGIVERS TO CHILDREN.
Periodontal diseases are socially significant diseases, which occur in adults but in children and adolescents as well. Despite a low prevalence of aggressive periodontitis at a young age, its severity is a challenge for...
INCIDENCE OF SECONDARY ROOT CARIES LESIONS IN PATIENTS REFERRED FOR TREATMENT IN THE FACULTY OF DENTAL MEDICINE – SOFIA.
Purpose: The aim of the presented study was to determine the incidence of secondary root caries lesions in patients referred for treatment in the Faculty of Dental Medicine – Sofia. Material/Methods: The subjects who to...
HERPES GESTATIONIS.
Herpes gestationis, also known as pemphigoidgestationis (PG) is an extremely rare autoimmune bullous dermatosis of the gestation and postpartum period. The disease was originally named herpes gestationis on the bas...
PATTERNS OF MAXILLOFACIAL INJURIES IN UNIVERSITY HOSPITAL ‘St. ANNA’, SOFIA.
Purpose: To compare the etiology, presentation, type of trauma in Department of maxillofacial surgery, University Hospital ‘St. Anna’, Sofia over a period of 4 years. Materials and methods: During the period of f...