Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

Abstract

Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy.Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant.Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ 2 =0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion:The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Introduction:The description about the thyroid gland is very prehistoric' for the first time it was name as "shield shape gland" by the Romans [1] . In the literature during 12 th or 13 th century not only the thyroid masses were mentioned but in 1170 Robert Frugard explained the complication of goiter. Thyroid surgery was begun in 12 th century by using hot iron, Setons and caustics powers (most results were fatal).At that time, the major advancement was, antisepsis, artery forceps and anesthesia to be practice [2] .The pioneers of thyroid surgery, Theodor Koches and Theodor Billroth, formulated many acceptable techniques of thyroid surgery between the year 1873 and 1883 [3] . In conventional method knot tying and ligation were important process. The very important thing of this operation is that the thyroid gland is one of the highly vascularized among all the organs having rich blood vessels and plexuses present in the parenchyma. This needs to be controlle...