Safety and Efficacy Study of Ultrasonic Coagulation Device and Bipolar Energy Sealing System

Study Overview
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Brief Summary
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The aim of the study is to evaluate differences between use of Ultrasonic Coagulation Device (New Harmonic ACE™, Ethicon endo-surgery) and Bipolar Energy Sealing System (LigaSure Precise™, Covidien) in surgery for thyroid cancer. Abbreviations: Ultrasonic Coagulation Device (UC), Bipolar Energy Sealing System (BES), Recurrence-free survival (RFS), Overall survival (OS)

Detailed Description
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Background: Thyroid is an organ that has abundant vessels. In thyroid surgery, it should be cautious to avoid injury of the recurrent laryngeal nerve and parathyroid, thus careful hemostasis during surgery is crucial for surgeons who perform thyroid surgery. Recently, there have been significant advances in vessel sealing systems for the occlusion of vessels during surgery as endoscopic surgery has been developed. UC and BES are now commonly used in thyroid surgery. However, only a few studies have compared the two surgical devices to determine which technique is superior in terms of operative time and complication rate. Thus, this single-blind prospective randomized trial is conducted to determine if there was a difference in operative time, complication rate, postoperative drainage volume, admission time, cost, and, furthermore, oncologic outcomes (RFS and OS) between the two surgical devices in surgery for thyroid cancer.

Official Title
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Comparison of Surgical Outcomes Between Papillary Thyroid Cancer Patients Treated With the Harmonic ACE® Scalpel and LigaSure Precise™ Instrument During Conventional Thyroidectomy: A Single-blind Prospective Randomized Controlled Trial

Conditions
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Thyroid Cancer

Intervention / Treatment
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* Device: Ultrasonic coagulation device (Harmonic ACE® scalpel)
* Device: bipolar energy sealing system (LigaSure Precise)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: an age between 20 and 80 years old who are diagnosed as thyroid cancer or suspicious papillary thyroid cancer in fine needle aspiration biopsy patients who are agree with the study enrollment Exclusion Criteria: an age under 20 or over 80 years severe co-morbidities that were contraindications for thyroid surgery (e.g., severe liver, heart, kidney, or pulmonary problems) a lack of consent to participate in the study the inability to include a patient in clinical trials according to the regulations or laws in Korea the inability to complete regular follow-up visits (e.g., immigration) the use of modified radical neck dissection due to lateral neck node metastasis prior thyroid surgery or cervical irradiation active enrollment in another clinical trial the intention of the patient to undergo an additional operation at the time of the thyroid surgery (e.g., mastectomy and thyroidectomy at the same time) the desire to undergo endoscopic or robot-assisted thyroidectomy

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Ultrasonic coagulation device<br>Comparison of Surgical Outcomes Between Papillary Thyroid Cancer Patients Treated with the Ultrasonic coagulation device (Harmonic ACE® Scalpel) and the bipolar energy sealing system (LigaSure Precise) during Conventional Thyroidectomy | Device: Ultrasonic coagulation device (Harmonic ACE® scalpel)<br>* Comparison of Surgical Outcomes Between Papillary Thyroid Cancer Patients Treated with the Ultrasonic coagulation device (Harmonic ACE® Scalpel) and the bipolar energy sealing system (LigaSure Precise) during Conventional Thyroidectomy<br>* Other names: Harmonic ACE® scalpel;|
| Other: Bipolar Energy Sealing System<br>Comparison of Surgical Outcomes Between Papillary Thyroid Cancer Patients Treated with the Ultrasonic coagulation device (Harmonic ACE® Scalpel) and the bipolar energy sealing system (LigaSure Precise) during Conventional Thyroidectomy | Device: bipolar energy sealing system (LigaSure Precise)<br>* Comparison of Surgical Outcomes Between Papillary Thyroid Cancer Patients Treated with the Ultrasonic coagulation device (Harmonic ACE® Scalpel) and the bipolar energy sealing system (LigaSure Precise) during Conventional Thyroidectomy<br>* Other names: LigaSure Precise instrument;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operation time | from skin incision to skin closure | from skin incision to skin closure at an average time of 60 min to 160 min according to the extent of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative complications |  | at 3 hours, 1, 2, 3, 10 days and 1 months after surgery and 6 months and every 1 years after surgery | 
| postoperative drainage volume |  | estimated until the drain tube is removed at the average of 4 to 7 days according to the extent of surgery | 
| admission time |  | documented when the patient leaves the hospital at an average time of 5 to 10 days according to the extent of surgery | 
| Cost |  | documented when the patient leaves the hospital at an average time of 5 to 10 days according to the extent of surgery | 
| Relapse-free survival (RFS) |  | from date of surgery until date of first documented recurrence or date of death from any cause, whichever came first, accessed up to 60 months | 
| Overall Survival (OS) |  | from date of surgery until date of death from any cause, accessed up to 60 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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operation time, complication rate, costs, admission time, RFS, OS