[Evaluation of the Ultracision ultrasonic dissector in thyroid surgery. Prospective randomized study].
OBJECTIVE
This prospective randomized study was designed to evaluate the efficacy, safety and cost of the ultrasonic hook in thyroid surgery, in comparison with conventional hemostasis.


METHODS
Thirty-four consecutive euthyroid patients with multinodular goiter undergoing total thyroidectomy were randomly assigned to either group I, Ultracision or group II, conventional hemostasis. Preoperative, intraoperative and postoperative biochemical, clinical, surgical and economic variables were compared in each group.


RESULTS
Use of the ultrasonic hook resulted in a significant reduction in operating time (70.7 +/- 18.3 versus 96.5 +/- 28.9 minutes), blood loss (74.5 +/- 50.9 g versus 134.6 +/- 108.42 g), and postoperative analgesic consumption (paracetamol (mg): 700 +/- 722 versus 1888 +/- 978), and may also reduce the incidence of transient hypoparathyroidism (5.8% versus 23.5%). The ultrasonic hook was no more expensive than conventional hemostasis, as long as a minimum of 15 patients shared the initial unit cost of the device.


CONCLUSIONS
Although the use of the ultrasonic dissector does not allow a major cost-saving in total thyroidectomy, the essential advantages were a significant reduction of intraoperative blood loss, length of operating time and postoperative analgesic consumption.
Service de chirurgie des glandes endocrines et transplantation, CHU Sart-Tilman, Liège, Belgique.
M
M
Meurisse
T
T
Defechereux
S
S
Maweja
C
C
Degauque
M
M
Vandelaer
E
E
Hamoir
D000328:Adult; D003362:Cost-Benefit Analysis; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional