TY - JOUR
T1 - The utility of the harmonic scalpel in selective neck dissection
T2 - A prospective, randomized trial
AU - Walen, Scott G.
AU - Rudmik, Luke R.
AU - Dixon, Elijah
AU - Matthews, T. Wayne
AU - Nakoneshny, Steven C.
AU - Dort, Joseph C.
PY - 2011/6
Y1 - 2011/6
N2 - Objectives. To determine the impact of the harmonic scalpel on intraoperative blood loss and operative time in selective neck dissection (SND) (levels I-IV) for head and neck squamous cell carcinoma (HNSCC). Study Design. Prospective randomized controlled trial. Setting. A single, tertiary care institution (Foothills Medical Centre) in Calgary, Alberta, Canada. Subjects. A total of 31 patients (36 neck dissections) were prospectively enrolled between January 2009 and March 2010. Methods. Patients were randomized to receive a neck dissection with either the harmonic scalpel or the traditional technique of using electrocautery and sharp dissection. The study included adult patients older than age 18 years diagnosed with HNSCC and who required an SND (levels I-IV). Study exclusion criteria included previous treatment for head and neck cancer and all patients unwilling or unable to provide informed consent. Primary clinical outcomes were intraoperative blood loss and operative time. Secondary outcomes included intraoperative complications and surgical drain output. Results. Intraoperative blood loss was significantly lower in the harmonic scalpel group compared to the traditional group (158 vs 61 mL, P = .02). There was no difference in operative time (81 minutes harmonic vs 85 minutes traditional) or total drain output (at both 48 hours and 1 week) between the groups. There were no intraoperative complications reported in either group. Conclusions. Results from this study suggest that the harmonic scalpel can reduce blood loss during SND for HNSCC. The harmonic scalpel had no impact on operative time, postoperative drain output, or complication rate.
AB - Objectives. To determine the impact of the harmonic scalpel on intraoperative blood loss and operative time in selective neck dissection (SND) (levels I-IV) for head and neck squamous cell carcinoma (HNSCC). Study Design. Prospective randomized controlled trial. Setting. A single, tertiary care institution (Foothills Medical Centre) in Calgary, Alberta, Canada. Subjects. A total of 31 patients (36 neck dissections) were prospectively enrolled between January 2009 and March 2010. Methods. Patients were randomized to receive a neck dissection with either the harmonic scalpel or the traditional technique of using electrocautery and sharp dissection. The study included adult patients older than age 18 years diagnosed with HNSCC and who required an SND (levels I-IV). Study exclusion criteria included previous treatment for head and neck cancer and all patients unwilling or unable to provide informed consent. Primary clinical outcomes were intraoperative blood loss and operative time. Secondary outcomes included intraoperative complications and surgical drain output. Results. Intraoperative blood loss was significantly lower in the harmonic scalpel group compared to the traditional group (158 vs 61 mL, P = .02). There was no difference in operative time (81 minutes harmonic vs 85 minutes traditional) or total drain output (at both 48 hours and 1 week) between the groups. There were no intraoperative complications reported in either group. Conclusions. Results from this study suggest that the harmonic scalpel can reduce blood loss during SND for HNSCC. The harmonic scalpel had no impact on operative time, postoperative drain output, or complication rate.
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U2 - 10.1177/0194599811403874
DO - 10.1177/0194599811403874
M3 - Article
C2 - 21493266
AN - SCOPUS:79961200838
VL - 144
SP - 894
EP - 899
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
SN - 0194-5998
IS - 6
ER -