Zhao Jing-Zhu, Gao Ming, Yu Yang, Li Yi-Gong, Li Xiao-Long, Wei Song-Feng, Liu You-Zhong, Gao Jian
Department of Thyroid & Neck Tumors, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
Department of Thyroid & Neck Tumors, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China. Email:
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Sep;48(9):752-7.
To compare the safety between harmonic scalpel and conventional resection in total or near total thyroidectomy with meta-analysis.
The prospective randomized controlled studies were searched for in electronic databases (MEDLINE, EMBASE, Cochrane Library). Meta analysis of acquired data was performed through the use of RevMan 5.2 software.
According to the inclusion criterion, 13 articles were enrolled which compared on the safety between harmonic scalpel and conventional resection in thyroid surgery. A total of 1620 patients with thyroid tumor were enrolled, including 802 patients in harmonic scalpel group and 818 patients in conventional resection group. Compared with conventional resection group, the harmonic scalpel group showed shorter time of surgery, the weighted mean difference (WMD) and their 95% confidence interval (95%CI) was -21.06[-25.65, -16.47], Z = 8.99, P < 0.00001; less intra-operative blood loss, WMD and 95%CI was -14.36[-20.67, -8.06], Z = 4.46, P < 0.00001; less post-operative drain output (WMD and 95%CI was -7.47[-11.35, -3.58], Z = 3.77, P = 0.0002); less hospitalization charges (WMD and 95%CI was -117.97[-131.65, -104.29], Z = 16.90, P < 0.00001). The incidence of postoperative transient recurrent laryngeal nerve dysfunction and transient hypocalcemia were similar in both groups.
Using the harmonic scalpel in thyroid surgery was as safe as that of the conventional technique with the advantage of shorter time of surgery, less intraoperative blood loss and less postoperative drain output.
采用Meta分析比较甲状腺全切除术或近全切除术中超声刀与传统切除术的安全性。
检索电子数据库（MEDLINE、EMBASE、Cochrane图书馆）中的前瞻性随机对照研究。使用RevMan 5.2软件对获得的数据进行Meta分析。
根据纳入标准，纳入13篇比较甲状腺手术中超声刀与传统切除术安全性的文章。共纳入1620例甲状腺肿瘤患者，其中超声刀组802例，传统切除术组818例。与传统切除术组相比，超声刀组手术时间更短，加权均数差（WMD）及其95%置信区间（95%CI）为-21.06[-25.65，-16.47]，Z = 8.99，P < 0.00001；术中出血量更少，WMD和95%CI为-14.36[-20.67，-8.06]，Z = 4.46，P < 0.00001；术后引流量更少（WMD和95%CI为-7.47[-11.35，-3.58]，Z = 3.77，P = 0.0002）；住院费用更低（WMD和95%CI为-117.97[-131.65，-104.29]，Z = 16.90，P < 0.00001）。两组术后暂时性喉返神经功能障碍和暂时性低钙血症的发生率相似。
甲状腺手术中使用超声刀与传统技术一样安全，具有手术时间短、术中出血量少和术后引流量少的优点。
