{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:51Z","timestamp":1753893291097,"version":"3.41.2"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Energy-based devices (EBD) have been popularized in thyroidectomy worldwide. Microdissection tungsten needle (MDTN) is characterized by the ultra-sharp tip providing safe and meticulous dissection with effective hemostasis. However, little study has applied MDTN in thyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study compared clinical data of the patients who underwent total thyroidectomy (TT) with central neck dissection (CND) using MDTN, harmonic scalpel (HS), and conventional electrocautery (CE). We assessed outcomes related to surgical efficacy and safety. The injury degree of tissue was assessed by biochemical indicators and early-stage inflammatory factors in the drainage fluid. Histological sections of the thyroid specimens were evaluated to compare levels of thermal damage by the three EBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant decrease in the intraoperative blood loss, operation time and 24-hour drainage volume in the MDTN group compared to the CE group. The total drainage volume, duration of drainage, and average length of stay of the MDTN group were less compared to the CE group though they did not reach statistical significance. No disparity was observed between the MDTN group and HS group in these variables. Total costs were not significantly different among these groups. The incidence of recurrent laryngeal nerve (RLN) injury was the lowest using MDTN compared to the CE (<jats:italic>P<\/jats:italic>\u2009=\u20090.034) and HS (not significant). No statistical differences were observed among these groups regarding postoperative wound pain and infection, hypoparathyroidism, and postoperative hemorrhage. Analysis of biochemical indicators showed a lower level of hemoglobin in the MDTN and HS group than the CE group (<jats:italic>P<\/jats:italic>\u2009=\u20090.046 and 0.038, respectively) and less triglyceride in the HS group than the MDTN and CE group (<jats:italic>P<\/jats:italic>\u2009=\u20090.002 and 0.029, respectively) but no significant difference in cholesterol level in these groups. Early-stage inflammatory factors including TNF-\u03b1 and IL-6 showed significantly higher concentration in the CE group than the MDTN and HS group. Histological sections of thyroid specimens revealed that MDTN caused the lowest degree of thermal damage followed by HS then CE.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MDTN exhibited comparable surgical efficacy and safety outcomes as HS in thyroidectomy. Therefore, MDTN is a safe and viable alternative for hemostasis in thyroidectomy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.896275","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T06:21:21Z","timestamp":1661494881000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Novel application of microdissection tungsten needle in total thyroidectomy with central neck dissection for papillary thyroid carcinoma"],"prefix":"10.3389","volume":"9","author":[{"given":"Weijie","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichong","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengrong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American thyroid association management guidelines for adult patients with thyroid nodules and\u00a0differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"B2","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1038\/s41574-018-0080-7","article-title":"Thyroid surgery for differentiated thyroid cancer - recent advances and future directions","volume":"14","author":"Wang","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.ecl.2018.11.003","article-title":"Conventional thyroidectomy in the treatment of primary thyroid cancer","volume":"48","author":"Roman","year":"2019","journal-title":"Endocrinol Metab Clin N Am"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2851","DOI":"10.1007\/s00405-018-5126-x","article-title":"Adherence to ATA 2015 guidelines in the management of unifocal non-invasive papillary thyroid cancer: a clinical survey among endocrinologists and surgeons","volume":"275","author":"Or","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1905","DOI":"10.1007\/s00405-015-3704-8","article-title":"Parathyroid function following total thyroidectomy using energy devices","volume":"273","author":"Ciftci","year":"2016","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1002\/lary.26271","article-title":"Safety of LigaSure in recurrent laryngeal nerve dissection-porcine model using continuous monitoring","volume":"127","author":"Dionigi","year":"2017","journal-title":"Laryngoscope"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1007\/s00405-018-4912-9","article-title":"Efficacy and safety of LigaSure\u2122 small jaw instrument in thyroidectomy: a 1-year prospective observational study","volume":"275","author":"Mao","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1002\/hed.24701","article-title":"Comparison of the safety of electrotome, Harmonic scalpel, and LigaSure for management of thyroid surgery","volume":"39","author":"Yang","year":"2017","journal-title":"Head Neck"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1002\/hed.24449","article-title":"Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: a systematic review and meta-analysis","volume":"38","author":"Cannizzaro","year":"2016","journal-title":"Head Neck"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1089\/thy.2012.0588","article-title":"Which hemostatic device in thyroid surgery? 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