Hemostasis in thyroid surgery: harmonic scalpel versus other techniques--a meta-analysis

Area of Science:

• Surgical Technology
• Minimally Invasive Surgery
• Endocrine Surgery

Background:

• Thyroidectomy is a common procedure with ongoing debate on optimal hemostasis techniques.
• Achieving safe, efficient, and cost-effective hemostasis is crucial in thyroid surgery.

Purpose of the Study:

• To systematically review and analyze literature comparing the harmonic scalpel with other hemostatic methods in thyroid surgery.
• To evaluate the efficacy and safety of the harmonic scalpel for hemostasis in thyroidectomy patients.

Main Methods:

• A systematic literature search was conducted using Medline and the Cochrane Library.
• Twelve prospective randomized controlled studies involving 1153 patients were included in this meta-analysis.
• Data were independently assessed by two reviewers.

Main Results:

• The harmonic scalpel significantly reduced operating time by approximately 25% (22.67 minutes) and blood loss by 20.03 mL.
• A statistically significant reduction in postoperative pain (0.86 points) and a trend towards shorter hospital stays (0.12 days) were observed.
• No significant differences were found in drainage fluid volume or complication rates compared to traditional methods.

Conclusions:

• The harmonic scalpel is a highly effective tool for achieving hemostasis in thyroid surgery.
• Its use leads to significant reductions in operative time and blood loss.
• The harmonic scalpel does not increase complication rates or drainage fluid volume, supporting its adoption in thyroidectomy.