Randomized controlled trial of harmonic scalpel use during thyroidectomy.
OBJECTIVE
To compare operative factors, postoperative outcomes, and surgical complications of thyroidectomy when using the harmonic scalpel (HS) vs conventional hemostasis (CH).


METHODS
Single-blind, randomized controlled trial.


METHODS
Department of Surgery, S. Chiara Hospital, University of Pisa, Pisa, Italy.


METHODS
One hundred patients undergoing thyroidectomy.


METHODS
Postoperative pain, drainage volume, hypocalcemia, nerve injury, and operative time.


METHODS
Patients underwent total thyroidectomy in which either the HS or CH was used.


RESULTS
We found no significant differences between the HS and CH groups at baseline. Postoperative pain was reduced in the HS group at 24 hours (mean visual analog scale score, 3.90 vs 5.30; P<.001) and 36 hours (2.27 vs 3.95; P<.001). Drainage volume was significantly lower in the HS group (40.1 mL vs 75.4 mL; P<.001). Transient hypocalcemia was significantly lower in the HS group (5 patients [10%] vs 16 [32%]; P=.01). No patients experienced nerve injury or permanent hypocalcemia. Mean operative times were shorter in the HS group (40.0 vs 46.7 minutes, P<.001).


CONCLUSIONS
Use of the HS may reduce postoperative pain, drainage volume, and transient hypocalcemia in patients undergoing thyroidectomy. Shorter operative times and improved outcomes might justify the cost of the HS compared with that of CH.
Miccoli
Paolo
P
Department of Surgery, University of Pisa, Pisa, Italy. p.miccoli@dc.med.unipi.it
Berti
Piero
P
Dionigi
Gianlorenzo
G
Dionigi
Gian L
GL
D'Agostino
Jacopo
J
Orlandini
Cinzia
C
Donatini
Gianluca
G
D000328:Adult; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013525:Surgical Instruments; D013965:Thyroidectomy / Q000295:instrumentation* / Q000379:methods; D014465:Ultrasonics