Korean J Endocr Surg.  2017 Mar;17(1):25-29. 10.16956/kaes.2017.17.1.25.

Total Thyroidectomy with Central Neck Dissection Using Harmonic Focus: A Randomized Clinical Trial

• Kim JS
• Kim HK
• Kim HY

• KMID: 2397989
• DOI: http://doi.org/10.16956/kaes.2017.17.1.25

Abstract

PURPOSE
The use of sealing devices such as Harmonic scalpel and Ligasure is increasing steadily in thyroid surgery. The Harmonic Focus (HF) is an ultrasonic device that enables simultaneous vessel sealing and tissue coagulation, designed for open surgery such as thyroidectomy. The aim of this study is to assess the efficiency and safety of HF use in thyroid surgery compared to Conventional Tying (CT).
METHODS
A prospective study was conducted to compare the efficacy of HF versus CT. We evaluated 50 patients who underwent surgery for thyroid tumor at Korea University Anam Hospital. All patients underwent total thyroidectomy with central neck dissection after being randomly allocated into two groups: HF group and CT group. The differences in surgical outcomes and postoperative complications by device use, i.e. group assignment, were statistically analyzed.
RESULTS
There were no differences in number of retrieved lymph nodes (P=0.595), number of resected parathyroid glands (P=0.330), immediate postoperative iPTH (P=0.252), length of hospitalization (P=0.375) between HF group and CT group. However, operative time was shorter in HF group than CT group (106.07±20.92 min vs. 136.54±38.24 min, P=0.046). Postoperative complications of wound infection, seroma, hematoma, chyle leakage, vocal cord palsy, and hypoparathyroidism did not differ between groups.
CONCLUSION
HF is a safe, effective, and time-saving technique; outcomes are comparable with CT. Both intraoperative and postoperative variables were similar between groups. Future larger studies are warranted to further investigate the effect on postoperative complications.

Keyword

Thyroidectomy; Central lymph node dissection; Harmonic focus; Conventional suture ligation

MeSH Terms

Chyle
Hematoma
Hospitalization
Humans
Hypoparathyroidism
Korea
Lymph Nodes
Neck Dissection*
Neck*
Operative Time
Parathyroid Glands
Postoperative Complications
Prospective Studies
Seroma
Thyroid Gland
Thyroidectomy*
Ultrasonics
Vocal Cord Paralysis
Wound Infection

Figure

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  Fig. 1 Comparison of study flow diagram.

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