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Neck dissection with harmonic scalpel and electrocautery? A randomised study.

Roshan K Verma1, Arulalan Mathiazhagan1, Naresh K Panda1

  • 1Department of Otolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.

Auris, Nasus, Larynx
|December 25, 2016
PubMed
Summary

The harmonic scalpel (HS) significantly reduces intraoperative blood loss during neck dissection for oral cancer compared to electrocautery (ET). Operative time and hospital stay remain unaffected by either technique.

Keywords:
Harmonic scalpelIntraoperative blood lossModified neck dissectionOperative timeOral squamous cell carcinomaPostoperative hospital stayRandomised clinical trial

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Area of Science:

  • Surgical Oncology
  • Head and Neck Surgery
  • Surgical Technology

Background:

  • Neck dissection is a critical procedure in oral cancer treatment.
  • Conventional electrocautery is widely used, but concerns exist regarding blood loss.
  • Limited high-level evidence exists comparing harmonic scalpel with electrocautery in neck dissections.

Purpose of the Study:

  • To evaluate the efficacy of the harmonic scalpel (HS) versus conventional electrocautery (ET) in neck dissection for oral cavity carcinoma.
  • To compare intraoperative blood loss, operative time, and postoperative outcomes between HS and ET.

Main Methods:

  • A prospective study involving 40 patients with primary oral cavity malignancy undergoing selective neck dissection.
  • Patients were randomized into two groups: 20 treated with harmonic scalpel (HS) and 20 with electrocautery (ET).
  • Key outcome measures included intraoperative blood loss, operative time, ligatures used, postoperative drain duration, and hospital stay.

Main Results:

  • Significantly reduced intraoperative blood loss was observed in the harmonic scalpel group compared to the electrocautery group.
  • No statistically significant differences were found in operative time, number of ligatures, postoperative drain duration, or hospital stay between the two groups.

Conclusions:

  • The harmonic scalpel is a valuable tool for reducing intraoperative blood loss in neck dissections for oral cancer.
  • Current evidence suggests no significant impact of harmonic scalpel use on operative time or postoperative hospital stay compared to electrocautery.