The effect of ultrasound dissection in thyroid surgery.
BACKGROUND
One of the most important aspects of thyroid surgery is hemostasis. The ultrasonically activated scalpel is described as a very useful instrument in thyroid surgery for the dissection and sealing of vessels. Our study compares the short-term results of endocrine surgery, with and without the use of ultrasonic devices.


METHODS
In a prospectively randomized trial, 96 patients with endemic goiter were operated by the same surgeon, one study group (n = 54 patients) being operated with the ultrasonic scalpel as an additional instrument. We measured the operating time, the number of ligatures needed as well as intraoperative and postoperative bleeding as surrogate markers for improvement of the surgical technique.


RESULTS
The ultrasound dissection technique significantly reduces surgery time (p = 0.048; ultrasound procedure average 68 min, conventional procedure average 83 min), intraoperative bleeding (p = 0.028) and the number of ligatures (p = 0.008; ultrasound procedure average 8.2, conventional procedure average 26.4).


CONCLUSIONS
The use of an ultrasonically activated scalpel significantly improves bleeding control during thyroid resections and may also be beneficial with respect to cost reduction. Clinical application and further studies to characterize its role are justified.
Witzel
K
K
Minimal Invasiv Center Hunfeld, Universitatsklinik fur Chirurgie, PMU Salzburg, Salzburg, Deutschland. kw@meinOP.de
von Rahden
B H A
BH
Stein
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006042:Goiter / Q000601:surgery; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011446:Prospective Studies; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014464:Ultrasonic Therapy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult