کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4285527 | 1611960 | 2016 | 11 صفحه PDF | دانلود رایگان |
BackgroundTo evaluate the incidence of postoperative complications, hemostatic effects and safety of Total Thyroidectomy (TT) performed using the Harmonic Scalpel (HS), the Harmonic Focus (HF) or Conventional Hemostasis (CH).MethodsThe meta-analysis was performed according to PRISMA guidelines. A literature search was conducted from 2003 to 2014 and stringent criteria were required for inclusion. Thirteen studies concerning an overall population of 1458 compared HS versus CH, whilst 8 studies with 1667 patients compared HF versus CH.ResultsThere was a significant reduction of operative time (Mean Difference [MD] = −25.49 min.; 95% CI −32.43 to −18.55), intraoperative blood loss (MD = −30.49 mL; 95% CI −53.01 to −7.97), postoperative drainage volume (MD = −12.90 mL; 95% CI −22.83 to −2.98) and postoperative pain (MD = −0.87; 95% CI −1.27 to −0.46) in patients underwent TT with HS.Regarding HF group, a significant reduction of operative time (MD = −25.99 min., 95% CI −34.56 to −17.41), length of hospital stay (MD = −0.57; 95% CI −0.97 to −0.17), transient hypocalcemia (OR = 0.56; 95% CI 0.39 to 0.81) and postoperative pain (MD = −1.33 days; 95% CI −2.49 to −0.17) resulted.ConclusionsHS TT can be a safe, useful and fast alternative to conventional TT. The newer HF can reduce the rate of hypocalcemia. Future RCTs of larger patient cohorts with more detailed data of postoperative complications, cost-effectiveness and cosmetic results, randomization procedures, intention-to-treat analyses and blinding of outcome assessors are needed to draw more meaningful conclusions.
Journal: International Journal of Surgery - Volume 28, Supplement 1, April 2016, Pages S22–S32