The clinical efficacy of the water jet dissection at the thyroid surgery (immediate results; quality of life)

Aim: reduction of the morbidity, disability and improved quality of life after surgery on the thyroid gland. Material and methods. Surgical treatment of the thyroid diseases have been performed to 56 patients. Mobilization of the thyroid gland and the separation of the pretracheal, preguttural and paratracheal tissues were performed by standard techniques using electrocoagulation and blunt separation of tissues in the control group. Mobilization of the thyroid gland and the separation of pretracheal, preguttural and paratracheal tissues were performed using a water-jet dissector ERBEjet 2 and the pressure of the water jet 25 bars in the main group of patients. Violations of voice (dysphonia), swallowing difficulties (dysphagia), the overall incidence of postoperative complications, length of postoperative hospital stay were markers of the effectiveness of the prevention of the damage of the recurrent laryngeal nerve afterthyroid surgery. Assessment of the quality of life of patients after surgery on the thyroid gland was performed before surgery, at 3 and 6 months after surgery. Results. Damage of the recurrent laryngeal nerve was not identified in any of the patient as a result of water jet dissection with pressure of the water jet 25 bars during the operation. Nerve function in the postoperative period were preserved in 100% (p <0.05). Application of the proposed method of preventing damage to the recurrent laryngeal nerve afterthyroid surgery resulted in a leveling of postoperative complications, as well as a statistically significant reduction of postoperative hospital stay. Using of the water jet dissection for mobilize of the thyroid and parathyroid tissues with a pressure of the water jet 25 bars significantly improves the quality of life of patients in the postoperative period. Conclusion. Application of the water jet dissection with pressure of the water jet 25 bars in thyroid surgery is a safe and effective method to prevent damage of the recurrent laryngeal nerve and improves the quality of life of patients in the postoperative period.