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The Efficacy of the Harmonic Scalpel in Neck Dissection: A Prospective Randomized Study

 Yoo Seob Shin  ;  Yoon Woo Koh  ;  Se-Heon Kim  ;  Eun Chang Choi 
 LARYNGOSCOPE, Vol.123(4) : 904-909, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Head and Neck Neoplasms/surgery* ; Hemostasis, Surgical/instrumentation* ; Humans ; Male ; Middle Aged ; Neck Dissection/methods* ; Prospective Studies ; Treatment Outcome
Harmonic scalpel ; neck dissection ; head and neck squamous cell carcinoma ; perioperative complications ; randomized clinical trial
OBJECTIVES/HYPOTHESIS: Recently, the Harmonic scalpel (HS) has been used in head and neck surgery as an alternative to conventional hand-tied ligation for hemostasis. Limited data have been published on the evidence of its safety in neck dissection (ND), especially in radical ND. We intended to investigate the safety and efficacy of the HS in ND, while using conventional hand-tied ligation to a minimum. METHOD: Fifty-nine patients who underwent ND with primary head and neck cancer resection were enrolled in this study. The group using HS consisted of 29 patients, and the conventional hand-tied ligation technique (CT) group comprised of 30 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications, the number of lymph nodes, total amount of drainage, duration of drain placement, and days of hospital stay. RESULT: The use of the HS reduced the operating time of comprehensive ND by an average of 46.5 minutes (P < 0.001), and blood loss was significantly decreased in the HS group than the CT group (163.8 ± 33.8 cc vs. 203.8 ± 36.5 cc, P = 0.002). The number of lymph nodes was not significantly different between the two groups. No significant difference was observed in the total amount of drainage, duration of drain placement, days of hospital stay, and perioperative complications. CONCLUSIONS: The HS is a relatively safe and effective alternative method for hand-tie ligation in ND. Moreover, the HS significantly reduced the operating time and amount of blood loss.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kho, Yoon Woo(고윤우)
Kim, Se Heon(김세헌)
Choi, Eun Chang(최은창)
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