Comparison of Unilateral Thyroidectomy Outcomes Using a Harmonic Scalpel Versus Electrocautery at Amnat Charoen Hospital
Keywords:
Thyroid gland, Thyroid lobectomy, Harmonic Scalpel, ElectrocauteryAbstract
Background: Traditional thyroid lobectomy using clamp, cut, tie, and electrocautery methods is time-consuming and poses risks to the recurrent laryngeal nerve. Therefore, the Harmonic Scalpel was used in unilateral thyroid surgery. Even though it costs more it has been widely accepted. It was found that it may reduce the time of surgery, reduce the amount of bleeding, and reduce damage to the laryngeal nerve.
Objective: To compare postoperative pain, operative time, hospital stay, and complications between thyroid lobectomy using the Harmonic Scalpel and conventional electrocautery.
Methods: The experimental study of patients who had undergone unilateral thyroid surgery at Amnat Charoen Hospital. From February 2024 to September 2024, 104 cases. The patients were randomly divided into 2 groups: a group that had surgery with Harmonic Scalpel, 52 cases, and a group that had surgery with cauterization and electrical tissue cutting, 52 cases. Compare patient information amount of bleeding during and after surgery vocal cord paralysis, postoperative hypothyroidism, and length of hospital stay. The post-operative pain quality of life and patient satisfaction including various complications. Statistics are used to analyze and compare continuous data with the Mann-Whitney U Test, as well as analyze and compare discrete data with the Chi-Square Test or Fisher's Exact Test.
Results: Patients undergoing Harmonic Scalpel cauterization had a shorter surgery time (65.0 minutes vs 97.5 minutes, p=0.006) and less bleeding (15.67 ml vs 50 ml, p<0.001). Pain levels were lower during the first 7 days after surgery (p<0.05), less pain medication was used (3.06 days vs 5.55 days, p<0.001), and there was a shorter hospital stay (3.23 days vs 4 days, p<0.001) with statistical significance. There were no significant differences in postoperative complications and thyroid function between the two groups.
Conclusion: Thyroid lobectomy using the Harmonic Scalpel significantly reduces intraoperative blood loss, operative time, postoperative blood loss, postoperative pain, analgesic use, and hospital stay without increasing the risk of complications.
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