Systematic Review of Comparison of use of Ultrasonic Scalpel Versus Conventional Haemostatic Techniques in Performing Thyroid Surgery
Tóm tắt
Haemostasis during any surgical procedure is fundamental for attaining a positive patient outcome. Safe thyroid surgery requires meticulous attention for careful control of bleeding and safe guarding important structures like recurrent laryngeal nerve. Many methods such as ligation and suturing, electro ligation sealing, coagulation, and ultrasonic coagulation have been put to use for achieving haemostasis. The objective of this systemic review was to compare and review the surgical outcomes between harmonic (ultrasonic) scalpel and conventional ligature techniques in performing thyroid surgery. The systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and checklist with a total of 11 studies selected for qualitative analysis. The statistical software Review Manager 5.4.1 provided by the Cochrane Collaboration was used for performing the analysis on the two groups. It was concluded that the use of harmonic scalpel for thyroid surgery is useful for reducing operative time, postoperative pain, drainage volume and transient hypocalcemia, hence can be a reliable and a safe tool compared to conventional techniques often used for surgery.
Tài liệu tham khảo
Smith RB, Coughlin A (2016) Thyroidectomy hemostasis. Otolaryngol Clin North Am 49:727–748. https://doi.org/10.1016/j.otc.2016.03.006
Ecker T, Carvalho AL, Choe JH et al (2010) Hemostasis in thyroid surgery: harmonic scalpel versus other techniques—a meta-analysis. Otolaryngol Head Neck Surg 143:17–25
Khafagy A, Abdelnaby I (2013) Total thyroidectomy: ligasure versus clamp & knot technique for intraoperative hemostasis, Egypt. J Ear Nose Throat Allied Sci 14:59–65. https://doi.org/10.1016/j.ejenta.2013.02.001
Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28:271–276. https://doi.org/10.1007/s00268-003-6903-1
Cannizzaro MA, Bianco SL, Borzì L, Cavallaro A, Buffone A (2014) The use of focus harmonic scalpel compared to conventional haemostasis (knot and tie ligation) for thyroid surgery: a prospective randomized study. Springerplus 3:639. https://doi.org/10.1186/2193-1801-3-639
Cirocchi R, D’Ajello F, Trastulli S, Santoro A, Di Rocco G, Vendettuoli D, Rondelli F, Giannotti D, Sanguinetti A, Minelli L, Redler A, Basoli A, Avenia N (2010) Meta-analysis of thyroidectomy with ultrasonic dissector versus conventional clamp and tie. World J Surg Oncol 23:8e112. https://doi.org/10.1186/1477-7819-8-112
Melck AL, Wiseman SM (2010) Harmonic scalpel compared to conventional hemostasis in thyroid surgery: a meta-analysis of randomized clinical trials. Int J Surg Oncol 2010:306079. https://doi.org/10.1155/2010/396079.ID396079
Garas G, Okabayashi K, Ashrafian H, Shetty K, Palazzo F, Tolley N, Darzi A, Athanasiou T, Zacharakis E (2013) Which hemostatic device in thyroid surgery? A network meta-analysis of surgical technologies. Thyroid 23(9):1138–1150. https://doi.org/10.1089/thy.2012.0588
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) The PRISMA group, preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. https://doi.org/10.1136/bmj.b2535
Manouras A, Markogiannakis HE, Kekis PB, Lagoudianakis EE, Fleming B (2008) Novel haemostatic devices in thyroid surgery: electrothermal bipolar vessel sealing system and harmonic scalpel. Expert Rev Med Devices 5(4):447–466. https://doi.org/10.1586/17434440.5.4.447
Dhepnorrarat RC, Witterick IJ (2013) New technologies in thyroid cancer surgery. Oral Oncol 49(7):659–664. https://doi.org/10.1016/j.oraloncology.2013.03.445
Pons Y, Gauthier J, Ukkola-Pons E, Clément P, Roguet E, Poncet JL, Conessa C (2009) Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg 141(4):496–501. https://doi.org/10.1016/j.otohns.2009.06.745
Ardito G, Revelli L, D’Alatri L, Lerro V, Guidi ML, Ardito F (2004) Revisited anatomy of the recurrent laryngeal nerves. Am J Surg 187:249–253. https://doi.org/10.1016/j.amjsurg.2003.11.001
Carlander J, Koch C, Brudin L, Nordborg C, Gimm O, Johansson K (2012) Heat production, nerve function, and morphology following nerve close dissection with surgical instruments. World J Surg 36:1361–1367. https://doi.org/10.1007/s00268-012-1471-x
Jiang Y, Gao B, Zhang X, Zhao J, Chen J, Zhang S, Luo D (2014) Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery. Int J Clin Exp Med 7(1):101–107
Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560. https://doi.org/10.1136/bmj.327.7414.557