Details

Autor(en) / Beteiligte

• Lee, Shen-Han
• Nguyen, Thien Khanh
• Ong, Whee-Sze
• Haaland, Benjamin
• Tay, Gerald Ci-An
• Tan, Ngian Chye
• Tan, Hiang Khoon
• Ng, Jeremy Chung Fai
• Iyer, N. Gopalakrishna

Titel

Comparing the Utility and Surgical Outcomes of Harmonic Focus Ultrasonic Scalpel with Ligasure Small Jaw Bipolar Device in Thyroidectomies: A Prospective Randomized Controlled Trial

Ist Teil von

• Annals of surgical oncology, 2019-12, Vol.26 (13), p.4414-4422

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2019

Link zum Volltext

Quelle

2022 ECC(Springer)

Beschreibungen/Notizen

• Background Ultrasonic or bipolar radiofrequency energy devices are routinely used for dissection and hemostasis during thyroidectomy. We report a single-center, prospective, randomized controlled trial comparing the utility and outcomes of Harmonic Focus, an ultrasonic coagulating shear device (UCSD), versus Ligasure Small Jaw, an electrothermal bipolar vessel sealer (EBVS) in thyroidectomy (NCT01765686). Methods Between December 2012 to January 2016, eligible patients were randomized to undergo hemithyroidectomy using either a UCSD or an EBVS. The primary outcome was duration of surgery. Secondary outcomes included blood loss, postoperative complications, ease of device use, ease of device set-up, vocal cord function, postoperative wound drainage, pain score, and adverse events. Results Of 110 patients assessed for eligibility, 100 were randomly allocated (UCSD: 49 patients; EBVS: 51 patients) and analyzed by intention-to-treat. There were no differences in specimen delivery time, total duration of surgery, wound drainage, and adverse events between the two groups. The UCSD group had a greater proportion of patients with higher postoperative pain scores in the first 72 h (8.1% vs. 2.0%, p  = 0.043). Surgeons reported greater ease of use for the UCSD (49% vs. 27%; p  = 0.005), while operating room staff favored the EBVS (60% vs. 33%, p  = 0.005). Conclusions Energy devices are equally effective in reducing thyroidectomy operative times, with no differences in the duration of surgery, drainage, or adverse events. Use of the UCSD was associated with higher postoperative pain scores, but was favored by the surgeons, likely due to the ability to perform fine dissection with the device itself.