title: Randomized controlled trial of harmonic scalpel use during thyroidectomy.
abstract: 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.
authors.affiliation: Department of Surgery, University of Pisa, Pisa, Italy. p.miccoli@dc.med.unipi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Miccoli
authors.forename: Piero
authors.initials: P
authors.lastname: Berti
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Gian L
authors.initials: GL
authors.lastname: Dionigi
authors.forename: Jacopo
authors.initials: J
authors.lastname: D'Agostino
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.forename: Gianluca
authors.initials: G
authors.lastname: Donatini
mesh_terms: 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