Morphologic changes in the nodular goitre induced by the LigaSure high frequency current generator

Abstract

Summary: Today, surgical dissection and tissue coagulation with both monopolar and bipolar coagulation as well as LigaSure high frequency current generator (HFCG) are the surgical modalities of choice in the treatment of thyroid pathology. However, the question of the high frequency current effect on the morphofunctional condition of the post hemithyroidectomic parenchyma is still disputable. The goal of the research is a thorough histological analysis of the surgically removed thyroid tissue specimen.The nodular goitre of 50 patients was subject to the histological study. The surgery was performed with the LigaSure HFCG. The 1.0x0.5 thyroid tissue specimens were excised from three areas. Hemithyroidectomy lasted for 40-50 min and thyroidectomy – 120 ± 4.2 min. In both procedures, the blood loss was within 70-150 ml, no haemorrhage being observed in both intra-and postoperative period.The zonal effect of high frequency current on the thyroid structure was determined morphologically, namely coagulation necrosis in the site of direct action, intensified secretory response of the thyroid tissue to the extremal factor in the perifocal area, and typical structure was determined morphologically, namely coagulation necrosis in the site of direct action, intensified secretory response of the thyroid tissue to the extremal factor in the perifocal area, and typical structure of the nodular goitre with the signs of impaired microcirculation in the remote area. Morphologic changes of the thyroid gland, with high frequency current used as a dissector, are distance-dependent.