Yao et al1 performed an important systematic review on the value of vessel sealing in thyroid resection. Based on 4 randomized and 5 nonrandomized studies (including 927 patients), they found that the LigaSure technique reduces the duration of surgery but has no apparent effect on clinically relevant end points, such as pain or hospital stay. These results, however, were limited by the presence of strong heterogeneity between the studies. In addition, Yao et al noted that smaller studies were significantly more likely to report significant positive results than larger ones. Therefore, the meta-analysis is apparently affected by publication bias, though the authors have made strenuous efforts to ensure that all eligible studies were found.
Sauerland S, Korenkov M. LigaSure for Vessel Ligation in Thyroidectomy. Arch Surg. 2010;145(5):501. doi:10.1001/archsurg.2010.56