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THE IMPACT OF HARMONIC SCALPEL ON COMPLICATIONS AFTER NECK DISSECTION IN PAPILLARY THYROID CARCINOMA: A PROSPECTIVE RANDOMIZED STUDY

Fahri Yetisir

Aim: The aim of this study was to investigate whether Harmonic Scalpel (HS) increases the complication rate in the patients undergoing neck dissection in patients with Papillary Thyroid Carcinoma (PTC).

Methods: 95 patients with PTC undergoing bilateral total thyroidectomy and central or lateral neck dissection were included in to study. Patients whom heamostasis was carried out using HS at each stage of the operation were classified as group I (n=52), and patients whom heamostasis was performed without HS in the dissection of nerves and in the dissection of regions containing parathyroids and ductus thoracicus as Group II (n=43). Groups were compared in terms of operation time, postoperative nerve injury, hypoparathyroidsm and development of chylous fistula.

Results: Demographic data, stage of tumor and type of operation were similar between groups. Mean operation time was 19 min. shorter in group I (p=0.003). There was no difference in nerve injury and hypoparathyroidsm between groups. Chylous fistula was seen in 3(5.7%) patients in group I. It was not seen in group II.

Conclusion: Use of HS in patients with PTC undergoing neck dissection decreases operation time significantly without increasing the rate of nerve and parathyroid injury, but may increase the risk of development of chylous fistula.