Study on The Use of Harmonic Scalpel vs Conventional Knot Tying in Open Thyroid Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WEI Tao , LI Zhihui , ZHU Jingqiang

Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Harmonic scalpel; 　Thyroid surgery

Video：

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Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). Methods One hundred and fifty-one patients and 70 patients underwent thyroid surgery with HS or CH respectively. The tumor diameter, incisional length, the total operative time, thyroidectomy time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared. The incisional length and the surgical complications in and after learning curve with harmonic scalpel were compared. Results There was no significant difference between the HS and CH group at baseline. Incisional length, total operative time, thyroidectomy time, intraoperative bleeding volume and postoperative drainage volume in HS group were significantly lower than those of CH group (P＜0.001); the surgical complications showed no significant difference between the HS and CH group (P gt;0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P＜0.05); the surgical complications after learning curve were significantly lower than that in learning curve in HS group (P＜0.001). Conclusion HS provides significant advantages over conventional hemostasis in open thyroid surgery. However, it can’t be used in a blindly exclusive way but be combined with conventional knot tying appropriately.

Citation： WEI Tao,LI Zhihui,ZHU Jingqiang. Study on The Use of Harmonic Scalpel vs Conventional Knot Tying in Open Thyroid Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(5): 323-326. doi: Copy

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5.	Erian M, McLaren GR, Buck RJ, et al. Reducing costs of laparoscopic hysterectomy [Ｊ]. J Am Assoc Gynecol Laparosc, 1999; 6(4)∶471.
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11.	Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: a randomized trial [Ｊ]. Ann Surg, 2000; 231(3)∶322.
12.	张冬坤, 郭朱明, 张诠，等. 超声刀在开放性甲状腺手术中的应用 [Ｊ]. 中国耳鼻咽喉头颈外科, 2006； 13(6)∶369.
13.	苏清华, 潘小明, 吴宣林. 甲状腺全切除术治疗甲状腺良性疾病 [Ｊ]. 中国普外基础与临床杂志, 2004； 11（6）∶493.
14.	Miccoli P, Berti P, Frustaci GL, et al. Video-assisted thyroidectomy: indications and results [Ｊ]. Langenbecks Arch Surg, 2006; 391(2)∶68.
15.	张彬, 安常明, 徐震纲, 等 .超声刀在甲状腺手术中的应用 [Ｊ]. 中国耳鼻咽喉头颈外科, 2006； 13(6)∶365.
16.	Miccoli P, Berti P,Raffaelli M, et al. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study [Ｊ]. Surgery, 2001; 130(6)∶1039.
17.	Zambudio AR, Rodríguez J, Riquelme J, et al. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery [Ｊ]. Ann Surg, 2004; 240(1)∶18.
18.	Echeverri A, Flexon PB. Electrophysiologic nerve stimulation for identifying the recurrent laryngeal nerve in thyroid surgery: review of 70 consecutive thyroid surgeries [Ｊ]. Am Surg, 1998; 64(4)∶328.
19.	Flynn MB, Lyons KJ, Tarter JW, et al. Local complications after surgical resection for thyroid carcinoma [Ｊ]. Am J Surg, 1994; 168(5)∶404.
20.	Kanehira E, Omura K, Kinoshita T， et al. How secure are the arteries occluded by a newly developed ultrasonically activated device? [Ｊ]. Surg Endosc, 1999; 13(4)∶340.

1. Amaral JF. The experimental development of an ultrasonically activated scalpel for laparoscopic use [Ｊ]. Surg Laparosc Endosc， 1994; 4(2)∶92.
2. Roye GD, Monchik J, Amaral JF. Endoscopic adrenalectomy using ultrasonic cutting and Coagulating [Ｊ]. Surg Technol Int， 2000; Ⅸ∶129.
3. Takao S, Shinchi H, Maemura K， et al. Ultrasonically activated scalpel is an effective tool for cutting the pancreas in biliary-pancreatic surgery: experimental and clinical studies [Ｊ]. J Hepatobiliary Pancreat Surg, 2000; 7(1)∶58.
4. Gertsch P, Pelloni A, Guerra A, et al. Initial experience with the harmonic scalpel in liver surgery [Ｊ]. Hepatogastroenterology， 2000; 47(33)∶763.
5. Erian M, McLaren GR, Buck RJ, et al. Reducing costs of laparoscopic hysterectomy [Ｊ]. J Am Assoc Gynecol Laparosc, 1999; 6(4)∶471.
6. Miccoli P, Berti P, Dionigi G, et al. Randomized controlled trial of harmonic scalpel use during thyroidectomy [Ｊ]. Arch Otolaryngol Head Neck Surg, 2006; 132(10)∶1069.
7. 郑民华, 李健文, 陆爱国, 等. 腹腔镜结直肠手术的学习曲线 [J]. 外科理论与实践， 2002； 7（3）∶187.
8. Siperstein AE, Berber E, Morkoyun E. The use of the harmonic scapel vs conventional knot tying for vessel ligation in thyroid surgery [Ｊ]. Arch Surg, 2002; 137(2)∶137.
9. Cordón C, Fajardo R, Ramírez J， et al. A randomized, prospective, parallel group study comparing the Harmonic Scalpel to electrocautery in thyroidectomy [Ｊ]. Surgery, 2005; 137(3)∶337.
10. Shemen L. Thyroidectomy using the harmonic scalpel: Analysis of 105 consecutive cases [Ｊ]. Otolaryngol Head Neck Surg, 2002; 127（4）∶284.
11. Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: a randomized trial [Ｊ]. Ann Surg, 2000; 231(3)∶322.
12. 张冬坤, 郭朱明, 张诠，等. 超声刀在开放性甲状腺手术中的应用 [Ｊ]. 中国耳鼻咽喉头颈外科, 2006； 13(6)∶369.
13. 苏清华, 潘小明, 吴宣林. 甲状腺全切除术治疗甲状腺良性疾病 [Ｊ]. 中国普外基础与临床杂志, 2004； 11（6）∶493.
14. Miccoli P, Berti P, Frustaci GL, et al. Video-assisted thyroidectomy: indications and results [Ｊ]. Langenbecks Arch Surg, 2006; 391(2)∶68.
15. 张彬, 安常明, 徐震纲, 等 .超声刀在甲状腺手术中的应用 [Ｊ]. 中国耳鼻咽喉头颈外科, 2006； 13(6)∶365.
16. Miccoli P, Berti P,Raffaelli M, et al. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study [Ｊ]. Surgery, 2001; 130(6)∶1039.
17. Zambudio AR, Rodríguez J, Riquelme J, et al. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery [Ｊ]. Ann Surg, 2004; 240(1)∶18.
18. Echeverri A, Flexon PB. Electrophysiologic nerve stimulation for identifying the recurrent laryngeal nerve in thyroid surgery: review of 70 consecutive thyroid surgeries [Ｊ]. Am Surg, 1998; 64(4)∶328.
19. Flynn MB, Lyons KJ, Tarter JW, et al. Local complications after surgical resection for thyroid carcinoma [Ｊ]. Am J Surg, 1994; 168(5)∶404.
20. Kanehira E, Omura K, Kinoshita T， et al. How secure are the arteries occluded by a newly developed ultrasonically activated device? [Ｊ]. Surg Endosc, 1999; 13(4)∶340.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Study on The Use of Harmonic Scalpel vs Conventional Knot Tying in Open Thyroid Surgery

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