甲状腺手术中谐波手术刀与传统止血方法的比较：一项随机临床试验的荟萃分析。

Harmonic scalpel compared to conventional hemostasis in thyroid surgery: a meta-analysis of randomized clinical trials.

作者信息

Melck Adrienne L, Wiseman Sam M

机构信息

Department of Surgery, Saint Paul's Hospital, University of British Columbia, C303-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.

出版信息

Int J Surg Oncol. 2010;2010:396079. doi: 10.1155/2010/396079. Epub 2010 Feb 16.

Background. The study's aim was to determine whether conventional hemostasis (CH) or the Harmonic Scalpel (HS) results in shorter operative times for thyroidectomy and to evaluate the incidence of postoperative complications with each approach. Methods. A literature search was conducted from study inception to September 30, 2008. Included studies randomized thyroidectomy patients to either CH or HS and reported the incidence of postoperative transient recurrent laryngeal nerve dysfunction (RLND) and hypocalcemia. Results. Nine RCTs were included. Use of the HS reduced operative time by 23.1 minutes (95% CI = 13.8, 32.33). There was no difference in the incidence of transient RLND (RR = 1.25, 95% CI = .56, 2.76), but a lower rate of transient hypocalcemia with the use of the HS (RR = .69, 95% CI = .51, .92). Conclusions. The use of HS in thyroidectomy significantly reduces operative time and is associated with a reduction in postoperative hypocalcemia compared to CH.

背景。本研究的目的是确定传统止血法（CH）或超声刀（HS）是否能使甲状腺切除术的手术时间更短，并评估每种方法术后并发症的发生率。方法。从研究开始至2008年9月30日进行文献检索。纳入的研究将甲状腺切除术患者随机分为CH组或HS组，并报告术后短暂性喉返神经功能障碍（RLND）和低钙血症的发生率。结果。纳入了9项随机对照试验。使用HS可使手术时间缩短23.1分钟（95%可信区间=13.8, 32.33）。短暂性RLND的发生率无差异（风险比=1.25, 95%可信区间=0.56, 2.76），但使用HS时短暂性低钙血症的发生率较低（风险比=0.69, 95%可信区间=0.51, 0.92）。结论。与CH相比，甲状腺切除术中使用HS可显著缩短手术时间，并可降低术后低钙血症的发生率。