دورية أكاديمية
Comparing the Utility and Surgical Outcomes of Harmonic Focus Ultrasonic Scalpel with Ligasure Small Jaw Bipolar Device in Thyroidectomies: A Prospective Randomized Controlled Trial.
العنوان: | Comparing the Utility and Surgical Outcomes of Harmonic Focus Ultrasonic Scalpel with Ligasure Small Jaw Bipolar Device in Thyroidectomies: A Prospective Randomized Controlled Trial. |
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المؤلفون: | Lee SH; Division of Surgical Oncology, National Cancer Centre, Singapore, Singapore.; Department of General Surgery, Singapore General Hospital, Singapore, Singapore., Nguyen TK; Division of Surgical Oncology, National Cancer Centre, Singapore, Singapore.; Department of General Surgery, Singapore General Hospital, Singapore, Singapore., Ong WS; Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore., Haaland B; Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.; Population Health Sciences, Division of Biostatistics, University of Utah, Salt Lake City, UT, USA., Tay GC; Department of General Surgery, Singapore General Hospital, Singapore, Singapore.; SingHealth Duke-NUS Head and Neck Centre, Singapore General Hospital, Singapore, Singapore., Tan NC; Division of Surgical Oncology, National Cancer Centre, Singapore, Singapore.; SingHealth Duke-NUS Head and Neck Centre, Singapore General Hospital, Singapore, Singapore., Tan HK; Division of Surgical Oncology, National Cancer Centre, Singapore, Singapore.; Department of General Surgery, Singapore General Hospital, Singapore, Singapore.; SingHealth Duke-NUS Head and Neck Centre, Singapore General Hospital, Singapore, Singapore., Ng JCF; Department of General Surgery, Singapore General Hospital, Singapore, Singapore.; SingHealth Duke-NUS Head and Neck Centre, Singapore General Hospital, Singapore, Singapore., Iyer NG; Division of Surgical Oncology, National Cancer Centre, Singapore, Singapore. gopaliyer@yahoo.com.; SingHealth Duke-NUS Head and Neck Centre, Singapore General Hospital, Singapore, Singapore. gopaliyer@yahoo.com. |
المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2019 Dec; Vol. 26 (13), pp. 4414-4422. Date of Electronic Publication: 2019 Sep 11. |
نوع المنشور: | Comparative Study; Journal Article; Randomized Controlled Trial |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
مواضيع طبية MeSH: | Electrocoagulation/*instrumentation , Hemostasis, Surgical/*instrumentation , Thyroid Diseases/*surgery , Thyroidectomy/*instrumentation , Ultrasonic Therapy/*instrumentation, Adult ; Aged ; Blood Loss, Surgical/prevention & control ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Pain, Postoperative/prevention & control ; Postoperative Complications/prevention & control ; Prospective Studies ; Surgical Instruments |
مستخلص: | Background: Ultrasonic or bipolar radiofrequency energy devices are routinely used for dissection and hemostasis during thyroidectomy. We report a single-center, prospective, randomized controlled trial comparing the utility and outcomes of Harmonic Focus, an ultrasonic coagulating shear device (UCSD), versus Ligasure Small Jaw, an electrothermal bipolar vessel sealer (EBVS) in thyroidectomy (NCT01765686). Methods: Between December 2012 to January 2016, eligible patients were randomized to undergo hemithyroidectomy using either a UCSD or an EBVS. The primary outcome was duration of surgery. Secondary outcomes included blood loss, postoperative complications, ease of device use, ease of device set-up, vocal cord function, postoperative wound drainage, pain score, and adverse events. Results: Of 110 patients assessed for eligibility, 100 were randomly allocated (UCSD: 49 patients; EBVS: 51 patients) and analyzed by intention-to-treat. There were no differences in specimen delivery time, total duration of surgery, wound drainage, and adverse events between the two groups. The UCSD group had a greater proportion of patients with higher postoperative pain scores in the first 72 h (8.1% vs. 2.0%, p = 0.043). Surgeons reported greater ease of use for the UCSD (49% vs. 27%; p = 0.005), while operating room staff favored the EBVS (60% vs. 33%, p = 0.005). Conclusions: Energy devices are equally effective in reducing thyroidectomy operative times, with no differences in the duration of surgery, drainage, or adverse events. Use of the UCSD was associated with higher postoperative pain scores, but was favored by the surgeons, likely due to the ability to perform fine dissection with the device itself. |
معلومات مُعتمدة: | Clinician-Scientist Award to N. Gopalakrishna Iyer National Medical Research Council |
سلسلة جزيئية: | ClinicalTrials.gov NCT01765686 |
تواريخ الأحداث: | Date Created: 20190913 Date Completed: 20200410 Latest Revision: 20200410 |
رمز التحديث: | 20240628 |
DOI: | 10.1245/s10434-019-07806-w |
PMID: | 31512024 |
قاعدة البيانات: | MEDLINE |
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