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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...

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Neck Dissection with Harmonic Instruments and Electrocautery: A Systematic Review.

Rogério Aparecido Dedivitis1,2, Leandro Luongo de Matos1,3, Mario Augusto Ferrari Castro4

  • 1Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.

International Archives of Otorhinolaryngology
|October 28, 2024
PubMed
Summary
This summary is machine-generated.

The harmonic scalpel (HS) significantly reduces operative time and blood loss during neck dissection (ND). This surgical technique also decreases draining fluid volume and the need for ligatures compared to traditional methods.

Keywords:
meta-analysisneck dissectionsquamous cell carcinomasurgical hemostasis

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Area of Science:

  • Otolaryngology
  • Surgical Oncology

Background:

  • Neck dissection (ND) is a critical surgical procedure.
  • Minimizing blood loss and operative time are key goals in ND.
  • Traditional hemostasis methods can be time-consuming and may lead to significant bleeding.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of the harmonic scalpel (HS) compared to traditional hemostasis in ND.
  • To evaluate the impact of HS on operative time, blood loss, and other relevant surgical outcomes.

Main Methods:

  • A comprehensive literature search was conducted in MEDLINE, EMBASE, and Cochrane Library databases (January 2007–August 2022).
  • Search terms included "harmonic scalpel OR ultrasonic scalpel" AND "neck dissection".
  • Ten randomized clinical trials involving 264 cases using HS and 262 cases without HS were selected for analysis.

Main Results:

  • The harmonic scalpel (HS) was associated with a significant reduction in operative time during neck dissection (ND).
  • Intraoperative bleeding volume was notably lower in the HS group compared to traditional methods.
  • The volume of draining fluid and the number of ligatures required were also significantly reduced with HS use.

Conclusions:

  • The harmonic scalpel (HS) is an effective tool for improving surgical efficiency and patient outcomes in neck dissection (ND).
  • HS offers advantages over traditional hemostasis by reducing operative time, blood loss, and postoperative fluid drainage.
  • The findings support the adoption of HS in neck dissection procedures to enhance surgical performance.