Prospective Comparison of the Effect on Antiadhesive Barriers During Thyroid or Parathyroid Surgery
Status:
Recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
Despite use of meticulous surgical techniques and regardless of surgical access via
conventional open or endoscopy, postoperative adhesions develop in the vast majority of
patients undergoing neck surgery. Such adhesions represent not only adhesion reformation at
sites of adhesiolysis, but also de novo adhesion formation at sites of surgical procedures.
Improved understanding of the pathophysiology of adhesion development and distinguishing
variations in the molecular biologic mechanisms represent future opportunities to improve the
reduction of postoperative adhesions.
After surgical tissue injury, there were local release of histamine, cytokines, and growth
factors that lead to adhesion development. Other than survival or safety issues, cosmetics
concerns and quality of life are the motifs after thyroid surgeries currently.
Pos-thyroidectomy adhesions include various symptoms such as neck discomfort, neck tightness,
skin adhesion to the trachea, skin scarring from adhesive reaction, and vocal cord palsy or
impairment of laryngeal vertical movement. Relief of the adhesion through wound massage or
anti-adhesion agents could reduce neck discomfort and voice changes.Although oxidized
regenerated cellulose (ORC) and hyaluronic acid (HA) appeared to be safe and effective to
decrease the incidence of adhesions, to improve adhesion-related neck discomfort, and to
prevent skin adhesion to the trachea after neck surgery. The application of antiadhesive
barriers after neck surgery is safe but the effect is still uncertain. Thus, we aim to
confirm the antiadhesive effect of multiple antiadhesive barriers in thyroid/parathyroid
surgery.