UltraCision harmonic scalpel versus clamp-and-tie total thyroidectomy: a clinical trial.
BACKGROUND
Hemostasis is important in thyroid surgery to avoid complications. Our aim was to evaluate the effectiveness of the harmonic scalpel in patients undergoing total thyroidectomy.


METHODS
In this study, 90 patients were randomized into group A (classic technique of tying and knots) and group B (harmonic scalpel). We recorded the following: age, sex, pathology, thyroid weight, hemostatic technique, duration of operation, change in calcemia (DeltaCa), change in hematocrit (DeltaHt), change in hemoglobin (DeltaHgb), change in white blood cell count (DeltaWBC), vocal motility, operative difficulty, postoperative vocal alteration, postoperative pain, complications, blood in the drains, operating time, mass of gland excised per minute, and hospitalization.


RESULTS
Differences (p < .05) were observed concerning duration of surgery, operative difficulty, postoperative pain, hospitalization, DeltaWBC, and quantity of gland removed per minute. No recurrent laryngeal nerve (RLN) palsies were observed.


CONCLUSIONS
Use of the Harmonic Scalpel in total thyroidectomy is more effective than the clamp-and-tie technique: the duration of surgery, intraoperative difficulty, postoperative pain, and hospitalization are reduced. Both techniques are equivalent concerning RLN injuries, postoperative vocal alterations, and blood loss.
Papavramidis
Theodossis S
TS
Third Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. papavramidis@hotmail.com
Sapalidis
Konstantinos
K
Michalopoulos
Nick
N
Triantafillopoulou
Konstantina
K
Gkoutzamanis
George
G
Kesisoglou
Isaak
I
Papavramidis
Spiros T
ST
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002118:Calcium / Q000097:blood; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D013965:Thyroidectomy / Q000295:instrumentation / Q000379:methods*
D002118:Calcium