title: FOCUS harmonic scalpel compared to conventional hemostasis in open total thyroidectomy - a prospective randomized study.
abstract: BACKGROUND
  Hemostasis in thyroid surgery is of utmost importance for a successful surgery and an uneventful postoperative course. Our aim was to evaluate the effectiveness of the FOCUS Harmonic Scalpel in patients undergoing open total thyroidectomy.
  
  
  METHODS
  In this study, 778 patients were randomized into 2 groups based on the surgical technique used: group I comprised the conventional clamp-and-tie technique, group II comprised patients in whom the FOCUS Harmonic Scalpel was used exclusively. The groups were compared in regard to surgical time, complications, and hospital stay.
  
  
  RESULTS
  Surgical time was significantly lower in group II compared with group I (79 ± 21.5 min vs.125 ± 30.4, respectively, P < 0.001). Twenty-seven patients (6.94%) in group I experienced symptomatic hypocalcemia requiring calcium and/or vitamin D therapy versus 14 patients (3.6%) in group II, with statistically significant difference (P < 0.05). Mean post-operative hospital stay was significantly lower in group II compared with group I (2.6 ± 0.9 vs. 2.9 ± 1.0; P < 0.001).
  
  
  CONCLUSIONS
  The FOCUS Harmonic Scalpel can shorten operative time and hospital stay, reduce incidence of symptomatic hypocalcemia but not transient hypoparathyroidism, and show no significance on recurrent nerve injury. FOCUS Harmonic Scalpel is supposed to be a more reliable and safe instrument that can take place of the clamp-and-tie technique in total thyroidectomy.
authors.forename: Yun-fei
authors.initials: YF
authors.lastname: Duan
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, Jiangsu 213003, China. czsdl@sina.com.
authors.forename: Dong-lin
authors.initials: DL
authors.lastname: Sun
mesh_terms: D004564:Electrocoagulation / Q000295:instrumentation; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008026:Ligation / Q000295:instrumentation; D011446:Prospective Studies; D013965:Thyroidectomy / Q000295:instrumentation; D014465:Ultrasonics