Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, University of Munich, LMU, Lindwurmstr. 2a, 80337, Munich, Germany.
Sci Rep. 2023 Mar 16;13(1):4365. doi: 10.1038/s41598-023-31328-x.
The cold scalpel/scissors (CS) and the monopolar electrocautery (ME) are still the most commonly used instruments for neck dissection in head and neck oncology. However, a direct comparison of these techniques does not exist. This study aims to compare these techniques concerning blood loss, the decline of hemoglobin levels, and surgery duration. Data on 200 patients who received tumor resection, neck dissection and either a radial forearm free flap (RFFF)or a primary closure (PC) were examined retrospectively. The patients were divided according to the performed defect closure (RFFF or PC) and the main instrument usedfor the beck dissection (Group 1: RFFF and ME, Group 2: RFFF and CS, Group 3: PC and ME Group 4: PC and CS). The intraoperative blood loss, decline of hemoglobin values and surgery duration were analyzed and compared between the corresponding groups. The patients where the ME was used lost on average 409.93 ml (group 1 vs. 2) and 242.4 ml (group 3 vs. 4) less blood. The median decrease in the hemoglobin levels was by 1.01 g/dL (group 1 vs. 2) and 0.85 g/dL (group 3 vs. 4) lower for the ME. The median surgery duration was by 102 min (group 1 vs. 2) and 83 min (group 3 vs. 4) shorterfor the ME. All differences were statistically significant. Traditional scalpel and scissors used for neck dissection lead to significantly higher blood loss and longer operation time than the monopolar electrocautery.
冷手术刀/剪刀（CS）和单极电烙术（ME）仍然是头颈肿瘤学中颈部解剖最常用的工具。然而，目前还没有这两种技术的直接比较。本研究旨在比较这两种技术在出血量、血红蛋白水平下降和手术持续时间方面的差异。回顾性分析了 200 例接受肿瘤切除术、颈部解剖术以及游离前臂桡侧皮瓣（RFFF）或一期闭合（PC）的患者数据。根据所行的缺损闭合（RFFF 或 PC）和用于颈部解剖的主要器械（第 1 组：RFFF 和 ME；第 2 组：RFFF 和 CS；第 3 组：PC 和 ME；第 4 组：PC 和 CS）对患者进行分组。分析并比较了相应组之间的术中出血量、血红蛋白值下降和手术持续时间。使用 ME 的患者平均失血量分别减少了 409.93ml（第 1 组 vs. 第 2 组）和 242.4ml（第 3 组 vs. 第 4 组）。ME 组血红蛋白水平中位数下降分别为 1.01g/dL（第 1 组 vs. 第 2 组）和 0.85g/dL（第 3 组 vs. 第 4 组）。ME 组的中位手术时间分别缩短了 102min（第 1 组 vs. 第 2 组）和 83min（第 3 组 vs. 第 4 组）。所有差异均具有统计学意义。传统的手术刀和剪刀用于颈部解剖会导致明显更高的出血量和更长的手术时间，而单极电烙术则不然。
