Application of fibrin sealant in patients operated on for differentiated thyroid cancer. What do we improve?

BackgroundIn recent years, several publications have shown that new adhesives and sealants, like Tissucol®, applied in thyroid space reduce local complications after thyroidectomies.Study aimsTo demonstrate the effectiveness of fibrin glue Tissucol® in reducing the post-operative hospital stay of patients operated on for differentiated thyroid carcinoma in which total thyroidectomy with central and unilateral node neck dissection was performed (due to the debit drains decrease), with consequent cost savings.Material and methodsA prospective randomised study was conducted during the period between May 2009 and October 2013 on patients with differentiated thyroid carcinoma with cervical nodal metastases, and subjected to elective surgery. Two groups were formed: one in which Tissucol® was used (case group) and another where it was not used (control group). Patients were operated on by surgeons specifically dedicated to endocrine surgical pathology, using the same surgical technique in all cases.ResultsA total of 60 total thyroidectomies with lymph node dissection were performed, with 30 patients in the case group, and 30 patients in control group. No statistically significant differences were observed in most of the studied variables. However, the case group had a shorter hospital stay than the control group with a statistically significant difference (p < 0.05).ConclusionImplementation of Tissucol® has statistically and significantly reduced the hospital stay of patients undergoing total thyroidectomy with neck dissection, which represents a significant reduction in hospital costs. This decrease in hospital stay has no influence on the occurrence of major complications related to the intervention.

ResumenAntecedentesEn los últimos años han aparecido diferentes publicaciones que demuestran que los nuevos sellantes adhesivos, como Tissucol®, que son aplicados en el espacio tiroideo reducen las complicaciones locales tras tiroidectomías complejas.ObjetivosMostrar la eficacia del adhesivo de fibrina Tissucol® en la reducción de la estancia hospitalaria postoperatoria de los pacientes intervenidos de carcinoma diferenciado de tiroides en quienes se realizó tiroidectomía total con vaciamiento ganglionar central y unilateral.Material y métodosRealizamos un estudio prospectivo y aleatorizado, durante el periodo comprendido entre mayo de 2009 y octubre de 2013, en pacientes con carcinoma diferenciado de tiroides con metástasis ganglionares cervicales, para la realización de cirugía programada. Se formaron 2 grupos: en los que se utilizó Tissucol® (grupo caso) y en los que no (grupo control). Los pacientes fueron operados por cirujanos especialmente dedicados a patología quirúrgica endocrina, utilizando la misma técnica en todos ellos.ResultadosRealizamos 60 tiroidectomías totales con vaciamiento ganglionar: 30 en el grupo caso, que se compararon con 30 del grupo control. No observamos diferencias significativas en la mayoría de las variables estudiadas; no obstante, el grupo caso presentó una menor estancia hospitalaria respecto al grupo control, con una diferencia estadísticamente significativa (p < 0.05).ConclusiónLa aplicación del Tissucol® ha permitido reducir la estancia hospitalaria de los pacientes operados de tiroidectomía total con vaciamiento cervical, lo que representa para el hospital una reducción de costos, sin que ello influya en la aparición de complicaciones relacionadas con la intervención.