INTRODUCTION: The aim of this study was to evaluate the potential advantages and the general operative cost of the Harmonic Scalpel (HS) in surgery for multinodular goiter (MNG). METHODS: Patients undergoing total thyroidectomy (TT) for MNG were prospectively allocated in a conventional tie-and-clip (TC) group (n = 50) and an HS group (n = 50). All pre- and postoperative data were recorded. The economic evaluation was based on a microcost measurement and aimed to consider all the resources consumed for each patient during the surgical procedure. To compare the results, we used the nonparametric unpaired two-tailed Mann-Whitney test. RESULTS: There were 81 women and 19 men (mean age, 55 +/- 15 years). Mean preoperative TSH level was 1.2 (SD, 1.1) (TC) and 1.3 (SD, 2) (HS) (P = NS). Mean body mass index was 24.72 (SD, 8) (TC) and 25.6 (SD, 8) (HS) (P = NS). Four patients experienced a transient hypocalcemia (2 in each group). One patient had a postoperative hematoma requiring surgical evacuation (HS). One patient experienced a transient recurrent nerve palsy (TC). Mean length of surgery was 104 (SD, 32) (TC) and 84 minutes (SD, 17) (HS) (P = .0001). Mean length of hospitalization was 2 days in both groups (SD, 1) (P = NS). Mean operative cost per patient was 990 euro (SD, 191) in the TC group and 1,024 euro (SD, 143) in the HS group (P = NS). CONCLUSION: Safety and efficiency of the HS is comparable to the tie-and-clip technique in thyroid surgery. The use of the HS in MNG surgery allows for a significant reduction in the length of the procedure with a comparable cost.
INTRODUCTION: The aim of this study was to evaluate the potential advantages and the general operative cost of the Harmonic Scalpel (HS) in surgery for multinodular goiter (MNG). METHODS:Patients undergoing total thyroidectomy (TT) for MNG were prospectively allocated in a conventional tie-and-clip (TC) group (n = 50) and an HS group (n = 50). All pre- and postoperative data were recorded. The economic evaluation was based on a microcost measurement and aimed to consider all the resources consumed for each patient during the surgical procedure. To compare the results, we used the nonparametric unpaired two-tailed Mann-Whitney test. RESULTS: There were 81 women and 19 men (mean age, 55 +/- 15 years). Mean preoperative TSH level was 1.2 (SD, 1.1) (TC) and 1.3 (SD, 2) (HS) (P = NS). Mean body mass index was 24.72 (SD, 8) (TC) and 25.6 (SD, 8) (HS) (P = NS). Four patients experienced a transient hypocalcemia (2 in each group). One patient had a postoperative hematoma requiring surgical evacuation (HS). One patient experienced a transient recurrent nerve palsy (TC). Mean length of surgery was 104 (SD, 32) (TC) and 84 minutes (SD, 17) (HS) (P = .0001). Mean length of hospitalization was 2 days in both groups (SD, 1) (P = NS). Mean operative cost per patient was 990 euro (SD, 191) in the TC group and 1,024 euro (SD, 143) in the HS group (P = NS). CONCLUSION: Safety and efficiency of the HS is comparable to the tie-and-clip technique in thyroid surgery. The use of the HS in MNG surgery allows for a significant reduction in the length of the procedure with a comparable cost.
Authors: A Bove; Ig Papanikolaou; G Bongarzoni; Pa Mattei; H Markogiannakis; M Chatzipetrou; V D'Addetta; Rm Di Renzo; M Fiordaliso; L Corbellini Journal: Hippokratia Date: 2012-04 Impact factor: 0.471
Authors: Gabriele Materazzi; Giuseppe Caravaglios; Valeria Matteucci; Aleksandr Aghababyan; Mario Miccoli; Paolo Miccoli Journal: Updates Surg Date: 2013-06-29
Authors: C Blanchard; F Pattou; L Brunaud; A Hamy; M Dahan; M Mathonnet; C Volteau; C Caillard; I Durand-Zaleski; E Mirallié Journal: BJS Open Date: 2017-05-09