Comparison of surgical outcomes of Ultrasonic technique (Harmonic Focus?) with Conventional technique in open hemithyroidectomy

摘要

Background: The option for dissection and haemostasis during thyroid surgery include either the modern ultrasonic technology (Harmonic Focus?) or the conventional technique using knot and ties, monopolar or bipolar electrocautery. Comparison between the surgical outcomes of open hemithyroidectomy using these two modalities was done.Objective: To compare the surgical outcomes of ultrasonic technique using Harmonic Focus? (HS) with Conventional technique (CT) in open hemithyoidectomy.Method: Twenty consecutive patients undergoing open hemithyroidectomy for benign solitary thyroid nodule of ≤ 3 cm were randomly assigned into two groups; group HS (n=10) and group CT (n=10). Analysis of surgical outcomes performed by these two techniques, particularly: operative time, intra-operative blood loss, post operative pain, incision size, complications and hospital stay were done.Results: The age, sex and pathologies were comparable in both the groups. For the group HS, mean operative time was (mean ± SD=55 ± 5 min) 15 minutes shorter than group CT (mean ± SD= 70 ± 10 min) (P<0.01). Mean operative blood loss was (mean ± SD=20 ±10 ml) 16 ml less in group HS than CT (mean ± SD= 36 ±12 ml) (P<0.01). The group HS experienced less post operative pain (mean ± SD=4 ± 0.94 VAS) than CT (mean ± SD= 7 ± 0.81 VAS) (P<0.001). The incision size at the time of skin closure was 1.6 cm shorter in group HS ((mean ± SD= 3.95 ±0.61 vs. 5.5 ± 0.78cm) (P<0.01). Hospital stay (mean ± SD= 2.30 ± 0.48 vs. 4.20 ±0.42 days) was statistically significant (P<0.01) in group HS than CT. There were no major complications.Conclusion: In patients undergoing open hemithyroidectomy, HS is a faster, better cosmetic, safe and less morbid tool than CT. Its use reduces operative time, blood loss, post operative pain, scar size, along with hospital stay.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11774 Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 175-180