The use of "harmonic scalpel" versus "knot tying" for conventional "open" thyroidectomy: results of a prospective randomized study.
OBJECTIVE
We evaluated the safety and cost-effectiveness of the harmonic scalpel (HS) during conventional "open" thyroidectomy (CT).


METHODS
Two hundred patients scheduled for conventional total thyroidectomy (TT) were included in the study and randomly assigned to TT with the use of HS (HS group) or with knot tying technique (KT group).


RESULTS
Mean operative time was significantly shorter in the HS group (P < 0.001), as well as the total operative room occupation time (P < 0.001). The cost of the disposable materials is significantly higher in the HS group (420.1 +/- 23.2 vs 137.8 +/- 25.3 euros; P < 0.001). Conversely, drugs, personnel and operative room charges were significantly higher in KT group patients (P < 0.001). Overall, no significant difference was found between the two groups concerning the charges of the hospitalisation (P = NS).


CONCLUSIONS
HS is a safe alternative to KT, allowing for a significant reduction of operative time without increasing complications rate and overall costs and probably better utilization of health resources.
Lombardi
Celestino Pio
CP
Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica, Universitá Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
Raffaelli
Marco
M
Cicchetti
Americo
A
Marchetti
Marco
M
De Crea
Carmela
C
Di Bidino
Rossella
R
Oragano
Luigi
L
Bellantone
Rocco
R
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques / Q000191:economics / Q000295:instrumentation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D013525:Surgical Instruments / Q000191:economics; D013536:Suture Techniques; D013965:Thyroidectomy / Q000191:economics / Q000295:instrumentation*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000191:economics / Q000295:instrumentation*