Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, USA.
Ann Surg Oncol. 2011 Jan;18(1):214-8. doi: 10.1245/s10434-010-1334-3. Epub 2010 Sep 18.
During the last few years, many surgeons have begun to utilize the LigaSure device or Harmonic scalpel to perform thyroid surgery. Several papers have demonstrated the benefits of these devices compared with traditional hand-tying techniques. The purpose of this study was to examine our institution's experience with the LigaSure device and Harmonic scalpel during thyroid surgery and to compare mean operative times and complications associated with each device.
A retrospective chart review was performed on all patients who underwent thyroid surgery using the LigaSure device or Harmonic scalpel at a single institution between December 2005 and August 2009. Charts were reviewed for patient demographics, mean operative time, length of stay, and complications, such as transient recurrent laryngeal nerve injury, hypocalcemia, and hematoma formation.
A total of 231 patients were included in the study, of whom 123 underwent total thyroidectomy and 108 underwent lobectomy. There was a significant decrease in the operative time for both thyroidectomies and lobectomies when the Harmonic scalpel was utilized. In regard to complications, there was no statistically significant difference in the number of transient and permanent recurrent laryngeal nerve injuries, percentage of patients developing hypocalcemia, or rate of hematoma development.
In this study, there was no difference in the rate of complications between the two devices. However, the use of the Harmonic scalpel significantly decreased operative time for both thyroidectomies and thyroid lobectomies compared with the LigaSure device.
在过去的几年中，许多外科医生开始使用 LigaSure 装置或 Harmonic 刀进行甲状腺手术。有几篇论文证明了这些设备与传统的手工结扎技术相比具有优势。本研究旨在检查我们机构在甲状腺手术中使用 LigaSure 装置和 Harmonic 刀的经验，并比较两种设备的平均手术时间和相关并发症。
对 2005 年 12 月至 2009 年 8 月期间在一家机构使用 LigaSure 装置或 Harmonic 刀进行甲状腺手术的所有患者进行了回顾性图表审查。对图表进行了审查，以了解患者的人口统计学特征、平均手术时间、住院时间以及并发症，如暂时性喉返神经损伤、低钙血症和血肿形成。
共有 231 例患者纳入研究，其中 123 例行甲状腺全切除术，108 例行甲状腺叶切除术。当使用 Harmonic 刀时，甲状腺全切除术和甲状腺叶切除术的手术时间均显著缩短。关于并发症，暂时性和永久性喉返神经损伤的数量、低钙血症的发生率或血肿形成的发生率均无统计学差异。
在本研究中，两种设备的并发症发生率没有差异。然而，与 LigaSure 装置相比，Harmonic 刀的使用显著缩短了甲状腺全切除术和甲状腺叶切除术的手术时间。
