[Ultrasonic scalpel in thyroid surgery].
In order to evaluate the harmonic scalpel during "open" thyroid surgery, a prospective randomized study was performed using the device versus the traditional procedure. One hundred and forty-two multinodular goiter patients were selected for total thyroidectomy and subdivided into two gender- and age-matched groups. In the first group of 72 patients, the surgical procedure was performed with the US scalpel without using any electrical device or vascular ligatures; in the second group of 70 patients, the traditional technique was employed. No statistically significant differences were recorded with regard to permanent inferior laryngeal nerve palsy or hypoparathyroidism rates. Use of the harmonic scalpel was associated with a higher incidence of transient nerve injury (P < or = 0.005, 9.7% vs 1.4%), but this difference disappeared with increasing experience with the harmonic scalpel. Using the US device significantly improves surgical duration (87.5% < 1 h) and blood loss (P < or = 0.005).
Marchesi
Maurizio
M
Dipartimento di Scienze Chirurgiche, Università degli Studi di Roma La Sapienza, Policlinico Umberto I, Viale Regina Elena 324, Roma.
Biffoni
Marco
M
Cresti
Riccardo
R
Mulas
Maria Maddalena
MM
Turriziani
Valeria
V
Berni
Alberto
A
Campana
Francesco Paolo
FP
D016063:Blood Loss, Surgical; D004867:Equipment Design; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D011446:Prospective Studies; D013525:Surgical Instruments; D013965:Thyroidectomy / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome; D014465:Ultrasonics