ABTRACT

Aim: To compare mean operating time, blood loss, post-operative hospital stay and post-operative complications of thyroid surgery with harmonic scalpel use and without harmonic scalpel.

Study Design: Randomized controlled trial.

Place and duration of study: Dept of Surgery, DHQ Teaching Hospital, DG Khan from 1^stJuly 2017 to 30^thJune 2019.

Methodology: One hundred cases of either gender with age more than 15 years undergoing thyroid surgery of any type were included in this study. The cases were distributed in two equal groups by simple lottery method. The cases in group A were managed with conventional hemostasis and those in B with harmonic and they were assessed for mean operative time, mean blood loss, mean postoperative hospital stay and number and types of post-operative complications.

Results: The mean age in group A and B was 40.22±5.96 vs 38.62±5.65 years. There were 41 (82%) females in group A and 40 (80%) in group B. Mean operative time in group A and B was 98.16±17.45 vs 84.38±9.34 minutes (p<0.001). Mean blood loss was 76.00±21.40 vs 64.50±16.04 mL (p = 0.003), and mean post-operative hospital stay was 3.12±0.74 vs 2.48±0.54 days in group A and B respectively with p=<0.001. Hypocalcemia was observed in 5(10%) vs 4 (8%), Surgical site infections were present in 5(10%) vs 2(4%) and signs of trauma to recurrent laryngeal nerve noted in 3 (6%) vs 1 (2%) in cases of group A and B.

Conclusion: Harmonic use in surgery of thyroid is significantly better than conventional hemostasis procedures as it resulted in reduced mean operative time, less estimated blood loss, less post-operative hospital stay and few numbers of complications.

Keywords: Thyroid, Harmonic, Hemostasis, Post-operative hospital stay