THE USE OF HARMONIC SCALPEL VERSUS KNOT TYING FOR TOTALTHYROIDECTOMY. A PROSPECTIVE RANDOMIZED STUDY | ||||
The Egyptian Journal of Surgery | ||||
Article 2, Volume 30, Issue 2, April 2011, Page 48-54 PDF (571.12 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejsur.2011.367367 | ||||
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Authors | ||||
Waleed Askar1; Hosam Roshdy* 1; Ayman El Nakeeb1; Ahmed Moatamed1; Ramadan El Lithy1; Salwa Hayes2 | ||||
1General Surgery Department, Faculty of Medicine, Mansoura University, Egypt | ||||
2Anesthesia Department, Faculty of Medicine, Mansoura University, Egypt | ||||
Abstract | ||||
Aim: Thyroidectomy is a surgical procedure that requires meticulous dissection, safe anatomical exposure and effective haemostasis. The aim of the present study is to compare the use of the harmonic scalpel with conventional haemostatic techniques in patients with benign thyroid enlargement undergoing total thyroidectomy Method: Consecutive patients treated for thyroid enlargement at our institution were evaluated for inclusion. Participants were randomly allocated to receive total thyroidectomy using harmonic scalpel (HS) or using ligature conventional thyroidectomy (CT), Study variables included operative time, length of incision, operative bleeding, postoperative drainage, hospital stay and complication. Results: one hundred and thirty patients with benign thyroid enlargement were randomized and completed the study. The mean incision length was 5.14±1.13 cm (4 -7 cm) in HS group and 8.78±1.4 cm (6-11 cm) in CT group p=0.04. Operative time was 50.27 ± 8.03 minutes for HS and 102.38 ± 14.63 minutes for CT (p=0.001). There was a significant difference in intraoperative bleeding and postoperative drainage between the two groups. Five patients (7.7%) in CT group and two patients (3.15%) in HS group experienced transient recurrent laryngeal nerve palsy (p= 0.24) .Two patients (3.15%) in HS group suffered from manifested hypocalcaemia and six patients (9.2%) in CT groups. Conclusion: HS is a safe, easier and effective alternative to knot tying technique for total thyroidectomy, allowing for a significant reduction of operative time, shorter incision, less intraoperative bleeding, less postoperative drainage without increasing complication rate. | ||||
Keywords | ||||
Thyroidectomy; recurrent laryngeal nerve palsy; hypocalcaemia | ||||
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