Harmonic scalpel versus conventional haemostasis in neck dissection: a prospective randomized study

Area of Science:

• Surgical Oncology
• Head and Neck Surgery
• Minimally Invasive Techniques

Background:

• Neck dissection (ND) is a critical procedure for head and neck squamous cell carcinoma (HNSCC).
• Optimizing operative factors and patient outcomes in ND remains a key focus in surgical practice.

Purpose of the Study:

• To compare the harmonic scalpel (HS) with conventional hemostasis (CH) in terms of operative factors, postoperative outcomes, and complications during ND for HNSCC.
• To evaluate the efficacy and safety of HS in reducing surgical morbidity.

Main Methods:

• Prospective randomized trial involving 61 patients with primary HNSCC undergoing ND.
• Patients were randomized into two groups: conventional hemostasis (CH) and harmonic scalpel (HS).
• Key outcomes measured included operative time, blood loss, drainage volume, pain, hospital stay, and complication rates.

Main Results:

• The HS group demonstrated significantly reduced operative time, intraoperative blood loss, postoperative pain, and drainage volume compared to the CH group.
• No significant differences were found in mean hospital stay or the incidence of perioperative and postoperative complications between the two groups.

Conclusions:

• The harmonic scalpel (HS) is a reliable and safe tool for neck dissection (ND) in HNSCC patients.
• HS effectively reduces intraoperative blood loss, operative time, drainage volume, and postoperative pain.
• Further multicenter randomized studies are warranted to confirm these advantages and assess the cost-benefit ratio.