Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

• Published in: International Journal of Surgical Oncology 2013-01, Vol.2013 (2013), p.39-46
• Main Authors: Ferri, Emanuele, Armato, Enrico, Spinato, Giacomo, Lunghi, Marcello, Tirelli, Giancarlo, Spinato, Roberto
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical - prevention & control; Cancer therapies; Clinical Study; Complications and side effects; Dissection; Female; Head & neck cancer; Head and Neck Neoplasms - surgery; Hematoma; Hemostasis, Surgical - methods; Hospitals; Humans; Larynx; Male; Methods; Middle Aged; Neck Dissection - adverse effects; Neck Dissection - instrumentation; Neck Dissection - methods; Operative Time; Otolaryngology; Pain; Pain, Postoperative - etiology; Patient outcomes; Patients; Postoperative Complications - etiology; Postoperative Hemorrhage - etiology; Prospective Studies; Radical neck dissection; Suctioning; Surgery; Surgical Instruments - adverse effects; Thyroid gland; Treatment Outcome; Ultrasonic transducers
• ISSN: 2090-1402; 2090-1410
• DOI: 10.1155/2013/369345

Purpose. The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy). Materials and methods. Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications. Results. The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications. Conclusion. The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.