Open Access, Peer-reviewed
pISSN 2508-8149
eISSN 2508-8459
    Korean J Endocr Surg. 2017 Mar;17(1):25-29. Korean.
    Published online Mar 23, 2017.
    https://doi.org/10.16956/kjes.2017.17.1.25
    Copyright © 2017. Korean Association of Thyroid and Endocrine Surgeons; KATES
    Original Article

    Total Thyroidectomy with Central Neck Dissection Using Harmonic Focus: A Randomized Clinical Trial

    Ji Seon Kim, Hong Kyu Kim and Hoon Yub Kim
      • Department of Surgery, Korea University College of Medicine, Seoul, Korea.
    • Correspondence: Hoon Yub Kim. Department of Surgery, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-2-920-5978, Fax: +82-2-928-1631, Email: hoonyubkim@gmail.com
    Received February 28, 2017; Revised March 02, 2017; Accepted March 03, 2017.

    This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    The use of sealing devices such as Harmonic scalpel and Ligasure is increasing steadily in thyroid surgery. The Harmonic Focus (HF) is an ultrasonic device that enables simultaneous vessel sealing and tissue coagulation, designed for open surgery such as thyroidectomy. The aim of this study is to assess the efficiency and safety of HF use in thyroid surgery compared to Conventional Tying (CT).

    Methods

    A prospective study was conducted to compare the efficacy of HF versus CT. We evaluated 50 patients who underwent surgery for thyroid tumor at Korea University Anam Hospital. All patients underwent total thyroidectomy with central neck dissection after being randomly allocated into two groups: HF group and CT group. The differences in surgical outcomes and postoperative complications by device use, i.e. group assignment, were statistically analyzed.

    Results

    There were no differences in number of retrieved lymph nodes (P=0.595), number of resected parathyroid glands (P=0.330), immediate postoperative iPTH (P=0.252), length of hospitalization (P=0.375) between HF group and CT group. However, operative time was shorter in HF group than CT group (106.07±20.92 min vs. 136.54±38.24 min, P=0.046). Postoperative complications of wound infection, seroma, hematoma, chyle leakage, vocal cord palsy, and hypoparathyroidism did not differ between groups.

    Conclusion

    HF is a safe, effective, and time-saving technique; outcomes are comparable with CT. Both intraoperative and postoperative variables were similar between groups. Future larger studies are warranted to further investigate the effect on postoperative complications.

    Keywords
    Thyroidectomy; Central lymph node dissection; Harmonic focus; Conventional suture ligation

    Figures

    Fig. 1
    Comparison of study flow diagram.

    Tables

    Table 1
    Comparison of the preoperative characteristics between the harmonic focus (HF) group and the conventional tying (CT) group

    Table 2
    Comparison of the surgical outcomes between the harmonic focus (HF) group and the conventional tying (CT) group

    Table 3
    Comparison of the postoperative morbidities between the harmonic focus (HF) group and the conventional tying (CT) group

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    MeSH Terms
    Chyle
    Hematoma
    Hospitalization
    Humans
    Hypoparathyroidism
    Korea
    Lymph Nodes
    Neck Dissection*
    Neck*
    Operative Time
    Parathyroid Glands
    Postoperative Complications
    Prospective Studies
    Seroma
    Thyroid Gland
    Thyroidectomy*
    Ultrasonics
    Vocal Cord Paralysis
    Wound Infection
    Metrics
    Share
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