title: The use of "harmonic scalpel" versus "knot tying" for conventional "open" thyroidectomy: results of a prospective randomized study.
abstract: 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.
authors.affiliation: Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica, Universitá Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Marco
authors.initials: M
authors.lastname: Raffaelli
authors.forename: Americo
authors.initials: A
authors.lastname: Cicchetti
authors.forename: Marco
authors.initials: M
authors.lastname: Marchetti
authors.forename: Carmela
authors.initials: C
authors.lastname: De Crea
authors.forename: Rossella
authors.initials: R
authors.lastname: Di Bidino
authors.forename: Luigi
authors.initials: L
authors.lastname: Oragano
authors.forename: Rocco
authors.initials: R
authors.lastname: Bellantone
mesh_terms: 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*