The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection: A prospective randomized study

Yoon Woo Koh, Jae Hong Park, Seung Won Lee, Eun Chang Choi

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the safety and efficacy of the no-tie (NT) technique using the harmonic scalpel (HS) in terms of the operating time and complications in total thyroidectomy with central neck dissection (CND). SUMMARY BACKGROUND DATA: Recently, the HS has been used as an alternative to conventional hand-tied ligation for hemostasis in thyroid surgery, which is a time-consuming procedure. Limited data have been published on the evidence of its safety in total thyroidectomy accompanied by CND without supplementary hand-tied ligation. METHODS: Sixty-five consecutive thyroidectomized patients were enrolled in this study. The final pathology in all the patients was thyroid papillary carcinoma. All patients underwent total thyroidectomy with CND. The NT technique using HS group consisted of 31 patients. The conventional hand-tied ligation technique group comprised 34 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications (hemorrhage, hematoma, seroma, recurrent laryngeal nerve palsy, hypoparathyroidism, and injury to the adjacent structures including the trachea and esophagus), the number of pathologically proven lymph nodes, total amount of drainage, duration of drain placement, and time of hospital discharge. RESULTS: The use of the HS reduced the operating time of total thyroidectomy with CND by an average of 43.12 minutes (P < 0.001). The number of pathologically proven lymph nodes was 7.32 ± 1.66 in the NT group and 6.85 ± 1.76 in the CT group (P = 0.274). No significant difference was observed in the overall perioperative complications, such as postoperative bleeding, temporary recurrent laryngeal nerve palsy, and temporary hypoparathyroidism, between the 2 groups. No permanent recurrent laryngeal nerve palsy and hypoparathyroidism occurred in either group. CONCLUSIONS: The NT technique with the HS is a relatively safe and effective method in total thyroidectomy combined with CND. Moreover, the HS significantly reduced the operating time.

Original languageEnglish
Pages (from-to)945-949
Number of pages5
JournalAnnals of surgery
Volume247
Issue number6
DOIs
Publication statusPublished - 2008 Jun 1

Fingerprint

Neck Dissection
Thyroidectomy
Ligation
Vocal Cord Paralysis
Hypoparathyroidism
Prospective Studies
Hand
Recurrent Laryngeal Nerve Injuries
Lymph Nodes
Hemorrhage
Safety
Seroma
Bleeding Time
Trachea
Hemostasis
Hematoma
Esophagus
Drainage
Thyroid Gland
Pathology

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{5c04f754ad9e41f3a1476d48533d9281,
title = "The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection: A prospective randomized study",
abstract = "OBJECTIVE: To investigate the safety and efficacy of the no-tie (NT) technique using the harmonic scalpel (HS) in terms of the operating time and complications in total thyroidectomy with central neck dissection (CND). SUMMARY BACKGROUND DATA: Recently, the HS has been used as an alternative to conventional hand-tied ligation for hemostasis in thyroid surgery, which is a time-consuming procedure. Limited data have been published on the evidence of its safety in total thyroidectomy accompanied by CND without supplementary hand-tied ligation. METHODS: Sixty-five consecutive thyroidectomized patients were enrolled in this study. The final pathology in all the patients was thyroid papillary carcinoma. All patients underwent total thyroidectomy with CND. The NT technique using HS group consisted of 31 patients. The conventional hand-tied ligation technique group comprised 34 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications (hemorrhage, hematoma, seroma, recurrent laryngeal nerve palsy, hypoparathyroidism, and injury to the adjacent structures including the trachea and esophagus), the number of pathologically proven lymph nodes, total amount of drainage, duration of drain placement, and time of hospital discharge. RESULTS: The use of the HS reduced the operating time of total thyroidectomy with CND by an average of 43.12 minutes (P < 0.001). The number of pathologically proven lymph nodes was 7.32 ± 1.66 in the NT group and 6.85 ± 1.76 in the CT group (P = 0.274). No significant difference was observed in the overall perioperative complications, such as postoperative bleeding, temporary recurrent laryngeal nerve palsy, and temporary hypoparathyroidism, between the 2 groups. No permanent recurrent laryngeal nerve palsy and hypoparathyroidism occurred in either group. CONCLUSIONS: The NT technique with the HS is a relatively safe and effective method in total thyroidectomy combined with CND. Moreover, the HS significantly reduced the operating time.",
author = "Koh, {Yoon Woo} and Park, {Jae Hong} and Lee, {Seung Won} and Choi, {Eun Chang}",
year = "2008",
month = "6",
day = "1",
doi = "10.1097/SLA.0b013e31816bcd61",
language = "English",
volume = "247",
pages = "945--949",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection : A prospective randomized study. / Koh, Yoon Woo; Park, Jae Hong; Lee, Seung Won; Choi, Eun Chang.

In: Annals of surgery, Vol. 247, No. 6, 01.06.2008, p. 945-949.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection

T2 - A prospective randomized study

AU - Koh, Yoon Woo

AU - Park, Jae Hong

AU - Lee, Seung Won

AU - Choi, Eun Chang

PY - 2008/6/1

Y1 - 2008/6/1

N2 - OBJECTIVE: To investigate the safety and efficacy of the no-tie (NT) technique using the harmonic scalpel (HS) in terms of the operating time and complications in total thyroidectomy with central neck dissection (CND). SUMMARY BACKGROUND DATA: Recently, the HS has been used as an alternative to conventional hand-tied ligation for hemostasis in thyroid surgery, which is a time-consuming procedure. Limited data have been published on the evidence of its safety in total thyroidectomy accompanied by CND without supplementary hand-tied ligation. METHODS: Sixty-five consecutive thyroidectomized patients were enrolled in this study. The final pathology in all the patients was thyroid papillary carcinoma. All patients underwent total thyroidectomy with CND. The NT technique using HS group consisted of 31 patients. The conventional hand-tied ligation technique group comprised 34 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications (hemorrhage, hematoma, seroma, recurrent laryngeal nerve palsy, hypoparathyroidism, and injury to the adjacent structures including the trachea and esophagus), the number of pathologically proven lymph nodes, total amount of drainage, duration of drain placement, and time of hospital discharge. RESULTS: The use of the HS reduced the operating time of total thyroidectomy with CND by an average of 43.12 minutes (P < 0.001). The number of pathologically proven lymph nodes was 7.32 ± 1.66 in the NT group and 6.85 ± 1.76 in the CT group (P = 0.274). No significant difference was observed in the overall perioperative complications, such as postoperative bleeding, temporary recurrent laryngeal nerve palsy, and temporary hypoparathyroidism, between the 2 groups. No permanent recurrent laryngeal nerve palsy and hypoparathyroidism occurred in either group. CONCLUSIONS: The NT technique with the HS is a relatively safe and effective method in total thyroidectomy combined with CND. Moreover, the HS significantly reduced the operating time.

AB - OBJECTIVE: To investigate the safety and efficacy of the no-tie (NT) technique using the harmonic scalpel (HS) in terms of the operating time and complications in total thyroidectomy with central neck dissection (CND). SUMMARY BACKGROUND DATA: Recently, the HS has been used as an alternative to conventional hand-tied ligation for hemostasis in thyroid surgery, which is a time-consuming procedure. Limited data have been published on the evidence of its safety in total thyroidectomy accompanied by CND without supplementary hand-tied ligation. METHODS: Sixty-five consecutive thyroidectomized patients were enrolled in this study. The final pathology in all the patients was thyroid papillary carcinoma. All patients underwent total thyroidectomy with CND. The NT technique using HS group consisted of 31 patients. The conventional hand-tied ligation technique group comprised 34 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications (hemorrhage, hematoma, seroma, recurrent laryngeal nerve palsy, hypoparathyroidism, and injury to the adjacent structures including the trachea and esophagus), the number of pathologically proven lymph nodes, total amount of drainage, duration of drain placement, and time of hospital discharge. RESULTS: The use of the HS reduced the operating time of total thyroidectomy with CND by an average of 43.12 minutes (P < 0.001). The number of pathologically proven lymph nodes was 7.32 ± 1.66 in the NT group and 6.85 ± 1.76 in the CT group (P = 0.274). No significant difference was observed in the overall perioperative complications, such as postoperative bleeding, temporary recurrent laryngeal nerve palsy, and temporary hypoparathyroidism, between the 2 groups. No permanent recurrent laryngeal nerve palsy and hypoparathyroidism occurred in either group. CONCLUSIONS: The NT technique with the HS is a relatively safe and effective method in total thyroidectomy combined with CND. Moreover, the HS significantly reduced the operating time.

UR - http://www.scopus.com/inward/record.url?scp=44449103797&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44449103797&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e31816bcd61

DO - 10.1097/SLA.0b013e31816bcd61

M3 - Article

C2 - 18520221

AN - SCOPUS:44449103797

VL - 247

SP - 945

EP - 949

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -