title: Modified lateral neck lymphadenectomy: prospective randomized study comparing harmonic scalpel with clamp-and-tie technique.
abstract: OBJECTIVE
  To compare the use of harmonic scalpel (HS) with clamp-and-tie technique to evaluate their comparative merits in modified lateral lymphadenectomy (LL).
  
  
  METHODS
  Prospective and randomized.
  
  
  METHODS
  Thirty-seven patients were recruited and divided into Group A (conventional; n = 20) and Group B (HS; n = 17). Thyroid volume, neck circumference, operative time, diameter of the tumor and lymph node, drainage volume, pain, and complications were compared. Operation consisted of thyroidectomy and LL.
  
  
  RESULTS
  Groups were homogeneous for thyroid volume, diameter of thyroid nodule and lymph node, and neck circumference. Operative time was shorter in Group B than in Group A. The fluid collection in the vacuum between 24 and 48 hours and the increase of neck circumference were lower in Group B. Pain was significantly lower in Group B after 12 hours and decrease was faster in Group B.
  
  
  CONCLUSIONS
  The use of HS during LL is as safe as conventional technique and may allow shorter operative time, lower lymphatic spillage, and faster decrease of pain.
authors.affiliation: Dipartimento di Chirurgia, Università di Pisa, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Miccoli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Materazzi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fregoli
authors.forename: Erica
authors.initials: E
authors.lastname: Panicucci
authors.forename: Walter
authors.initials: W
authors.lastname: Kunz-Martinez
authors.forename: Piero
authors.initials: P
authors.lastname: Berti
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D011446:Prospective Studies; D013965:Thyroidectomy / Q000379:methods; D014464:Ultrasonic Therapy / Q000379:methods