Endocrine Abstracts

Introduction: During thyroidectomy, topical hemostatic agents (THA) (i.e. oxidized regenerated cellulose) are commonly used. The aims of this study are i) to evaluate the resolution duration of these materials sold under different brand names in the surgical bed. ii) to prospectively describe their ultrasonographic characteristics.

Methods: A total of 67 patients who underwent thyroidectomy for various reasons and had THA used during surgery were included in the study. Demographic characteristics, reason for operation, type of surgery, pathology results, type of THA used, and postoperative ultrasonographic features of these patients were recorded.

Findings: The mean age of the patients was 45.02±13.5 years, with 14(20.8%) being male. The postoperative initial ultrasound (US) evaluation times of TMA varied from 1 to 84 months; however, the first US evaluation was performed within 9 months postoperatively in 42(62.6%) patients. The observed US pattern of TMA in all patients was ovoid/round, markedly hypoechoic solid lesions with well-defined margins. Linear parallel echogenic bands were observed in some cases. No vascularity was detected in any of them on Doppler US. Prospective sonographic follow-up of at least 6 months were conducted in 34 patients. Among these patients, the volume of TMA decreased in 13(38.2%), remained stable in 10 (29.4%), and increased in 11(32.3%). Throughout the follow-up period, TMA completely disappeared in none of the patients. In the patient with the longest follow-up duration, TMA was still detected at the postoperative 84^th month. The type of TMA used could be identified in 36 patients. In all patients, although the trade names differed, oxidized regenerated cellulose was used as TMA; Surgicel® in 7 (19.4%) and Pahacel® in 29 (80.6%) patients. Among the 13 patients whose TMA volume decreased during follow-up of at least 6 months, 6(46.1%) had used Pahacel® and 2(15.3%) had used Surgicel®. Among the 21 patients whose TMA volume increased or remained stable, 10(47.6%) were identified to have used Pahacel®.

Conclusion: Our study showed a longer resolution time than the data provided by the producers. Understanding and accurately recognizing the ultrasonographic characteristics of these agents is particularly important in reducing diagnostic errors in malignant cases during the postoperative period, and in preventing unnecessary imaging and invasive tests conducted due to suspicion of recurrence.