title: The efficacy of the harmonic scalpel in neck dissection: a prospective randomized study.
abstract: OBJECTIVE
  Recently, the Harmonic scalpel (HS) has been used in head and neck surgery as an alternative to conventional hand-tied ligation for hemostasis. Limited data have been published on the evidence of its safety in neck dissection (ND), especially in radical ND. We intended to investigate the safety and efficacy of the HS in ND, while using conventional hand-tied ligation to a minimum.
  
  
  METHODS
  Fifty-nine patients who underwent ND with primary head and neck cancer resection were enrolled in this study. The group using HS consisted of 29 patients, and the conventional hand-tied ligation technique (CT) group comprised of 30 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications, the number of lymph nodes, total amount of drainage, duration of drain placement, and days of hospital stay.
  
  
  RESULTS
  The use of the HS reduced the operating time of comprehensive ND by an average of 46.5 minutes (P < 0.001), and blood loss was significantly decreased in the HS group than the CT group (163.8 ± 33.8 cc vs. 203.8 ± 36.5 cc, P = 0.002). The number of lymph nodes was not significantly different between the two groups. No significant difference was observed in the total amount of drainage, duration of drain placement, days of hospital stay, and perioperative complications.
  
  
  CONCLUSIONS
  The HS is a relatively safe and effective alternative method for hand-tie ligation in ND. Moreover, the HS significantly reduced the operating time and amount of blood loss.
authors.affiliation: Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Yoo Seob
authors.initials: YS
authors.lastname: Shin
authors.forename: Yoon Woo
authors.initials: YW
authors.lastname: Koh
authors.forename: Se-Heon
authors.initials: SH
authors.lastname: Kim
authors.forename: Eun Chang
authors.initials: EC
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome