Energy-Based Devices Affect the Aesthetic Outcome of Cervical Thyroidectomy and Parathyroidectomy. A Retrospective Study
Authors:   Division of Surgery, Department of Human Pathology in Adulthood and Childhood ‘’G. Barresi’‘,  University Hospital G. Martino, University of Messina, Italy, Pino Antonella , Gasco Lorenzo ,   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Human Pathology in  Adulthood and Childhood ‘’G. Barresi’’, University Hospital G. Martino, University of Messina, Italy, Zhang Daqi ,   Jilin Provincial Key Laboratory of Surgical Translational Medicine, China Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun city, Jilin Province, China, Carcoforo Paolo ,   Department of Surgery, University of Ferrara, Ferrara, Italy, Micieli Pietro ,   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Human Pathology in  Adulthood and Childhood ‘’G. Barresi’’, University Hospital G. Martino, University of Messina, Italy, Delia Gabriele ,   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Human Pathology in  Adulthood and Childhood ‘’G. Barresi’’, University Hospital G. Martino, University of Messina, Italy, Frattini Francesco ,   Division of Surgery, AST Varese, Varese, Italy, Dionigi Gianlorenzo ,   Division of Surgery, Istituto Auxologico Italiano IRCCS, Milan, Italy, d’Alcontres Francesco Stagno ,   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Human Pathology in  Adulthood and Childhood ‘’G. Barresi’’, University Hospital G. Martino, University of Messina, Italy
Published: November 2021

Introduction: Thyroid and parathyroid diseases are very common. Most of these cases are in women and may be amenable to surgery. The patient’s perception that these are not life-threatening diseases leads them to expect an excellent aesthetic result, since the surgical incision area is clearly visible. Objective: To evaluate different scarring outcomes using three different energy-based devices (Harmonic Focus®, Johnson & Johnson, New Brunswick, NJ; Thunderbeat Open Fine Jaw®, Olympus Medical, Tokyo, Japan; LigaSure Small Jaw®, Medtronic, Dublin, Ireland) and to determine the impact of post-thyroidectomy/parathyroidectomy scars on the patient’s quality of life. Methods: One hundred female patients who underwent thyroidectomy or parathyroidectomy between September 2017 and September 2019 at the Endocrine and Minimally Invasive Surgery Department of Messina University Hospital were recruited. A retrospective analysis assessed the thickness of the cervical scar via ultrasound imaging, and the patient’s degree of satisfaction through the Patient and Observer Scar Assessment Scale (POSAS) and the Body Dysmorphic Disorder Questionnaire (BDDQ). Results: The patients were divided into three groups according to the energy-device used: group A (LigaSure SJ (n=38), group B (Harmonic F, n=32) and group C (Thunderbeat OFJ, n=30). The three groups were homogeneous with respect to number of patients, age and surgical procedures. The best aesthetic result, which correlated with the lowest scar thickness, was observed in group A; these patients were more satisfied than those in the other two groups. Moreover, correlations between scar thickness and quantitative variables (such as age or BMI) were not found in any of the groups. Conclusions: Based on the data collected and our experience, the LigaSure Small Jaw® (Medtronic) seems to offer the best aesthetic outcome in patients who undergo transverse cervicotomy for thyroid and parathyroid diseases. However, further prospective studies involving a greater number of cases are needed.