Prospective, case-control study of surgical efficiency of ultrasonic shear ('harmonic scalpel') thyroidectomy compared with conventional thyroidectomy.

摘要

OBJECTIVES AND HYPOTHESIS: To evaluate the efficacy of ultrasonic shear ('harmonic scalpel') thyroidectomy, compared with conventional thyroidectomy. STUDY DESIGN: Prospective, case-control comparison. METHODS: Twenty-three consecutive patients were recruited over an eight-month period. Patients were divided into two groups according to their thyroidectomy technique, i.e. ultrasonic shear technique (harmonic scalpel) vs conventional technique (scalpel and bipolar diathermy). Surgical time, thyroidectomy type and thyroid specimen weight were recorded by theatre nursing staff. The ratio of surgical time to specimen weight, in minutes per gram, was used to measure surgical efficiency. The unpaired Student's t-test was used for statistical analysis. RESULTS: The mean surgical time per specimen unit weight was 2.56 min/g for harmonic scalpel thyroidectomy and 5.99 min/g for conventional thyroidectomy. This difference was statistically significant (p = 0.037). The difference was most evident for procedures involving smaller thyroid glands. CONCLUSIONS: Our study suggests that thyroidectomy using a harmonic scalpel is more time-efficient than conventional thyroidectomy, especially when operating on smaller thyroid glands.