Harmonic scalpel versus conventional haemostasis in neck dissection: a prospective randomized study.
OBJECTIVE
The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy).


METHODS
Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications.


RESULTS
The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications.


CONCLUSIONS
The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.
Otorhinolaryngology Department ULSS 17, General Hospital of Monselice, Via G. Marconi 19, Monselice, 35043 Padua, Italy.
Emanuele
E
Ferri
Otorhinolaryngology Department ULSS 13, General Hospitals of Dolo and Mirano, Via Mariutto 76, Mirano, 30035 Venice, Italy.
Enrico
E
Armato
Head and Neck Department, ENT Clinic, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
Giacomo
G
Spinato
Otorhinolaryngology Department ULSS 17, General Hospital of Monselice, Via G. Marconi 19, Monselice, 35043 Padua, Italy.
Marcello
M
Lunghi
Head and Neck Department, ENT Clinic, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
Giancarlo
G
Tirelli
Otorhinolaryngology Department ULSS 13, General Hospitals of Dolo and Mirano, Via Mariutto 76, Mirano, 30035 Venice, Italy.
Roberto
R
Spinato
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D013525:Surgical Instruments / Q000009:adverse effects*; D016896:Treatment Outcome