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Randomized Controlled Trial
. 2006 Oct;132(10):1069-73.
doi: 10.1001/archotol.132.10.1069.

Randomized controlled trial of harmonic scalpel use during thyroidectomy

Paolo Miccoli  1 , Piero Berti, Gianlorenzo Dionigi, Jacopo D'Agostino, Cinzia Orlandini, Gianluca Donatini
Affiliations
Free article
Randomized Controlled Trial

Randomized controlled trial of harmonic scalpel use during thyroidectomy

Paolo Miccoli et al. Arch Otolaryngol Head Neck Surg. 2006 Oct.
Free article

Erratum in

  • Arch Otolaryngol Head Neck Surg. 2006 Dec;132(12):1351. Dionigi, Gian L [corrected to Dionigi, Gianlorenzo]

Abstract

Objective: To compare operative factors, postoperative outcomes, and surgical complications of thyroidectomy when using the harmonic scalpel (HS) vs conventional hemostasis (CH).

Design: Single-blind, randomized controlled trial.

Setting: Department of Surgery, S. Chiara Hospital, University of Pisa, Pisa, Italy.

Patients: One hundred patients undergoing thyroidectomy.

Main outcome measures: Postoperative pain, drainage volume, hypocalcemia, nerve injury, and operative time.

Intervention: Patients underwent total thyroidectomy in which either the HS or CH was used.

Results: We found no significant differences between the HS and CH groups at baseline. Postoperative pain was reduced in the HS group at 24 hours (mean visual analog scale score, 3.90 vs 5.30; P<.001) and 36 hours (2.27 vs 3.95; P<.001). Drainage volume was significantly lower in the HS group (40.1 mL vs 75.4 mL; P<.001). Transient hypocalcemia was significantly lower in the HS group (5 patients [10%] vs 16 [32%]; P=.01). No patients experienced nerve injury or permanent hypocalcemia. Mean operative times were shorter in the HS group (40.0 vs 46.7 minutes, P<.001).

Conclusions: Use of the HS may reduce postoperative pain, drainage volume, and transient hypocalcemia in patients undergoing thyroidectomy. Shorter operative times and improved outcomes might justify the cost of the HS compared with that of CH.

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