Document Detail

Randomized controlled trial of harmonic scalpel use during thyroidectomy.
MedLine Citation:
PMID:  17043253     Owner:  NLM     Status:  MEDLINE    
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.
Paolo Miccoli; Piero Berti; Gianlorenzo Dionigi; Gian L Dionigi; Jacopo D'Agostino; Cinzia Orlandini; Gianluca Donatini
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  132     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-17     Completed Date:  2006-11-09     Revised Date:  2007-01-11    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-73     Citation Subset:  AIM; IM    
Department of Surgery, University of Pisa, Pisa, Italy.
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MeSH Terms
Hemostasis, Surgical / instrumentation*,  methods
Middle Aged
Single-Blind Method
Surgical Instruments*
Thyroidectomy / instrumentation*,  methods
Erratum In:
Arch Otolaryngol Head Neck Surg. 2006 Dec;132(12):1351
Note: Dionigi, Gian L [corrected to Dionigi, Gianlorenzo]

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