ÖZAmaç: Tiroidektomide konvansiyonel tekniğin (KT) yıllardır güvenle uygulandığı bilinmektedir. Ancak teknolojinin ilerlemesi tiroid cerrahisinde de değişikliklere yol açmaktadır. Harmonic Scalpel (HS), bu yeni teknolojik cihazlardan biri olup elektrik enerjisini ultrasonik enerjiye çevirerek uç kısmındaki bıçakların yüksek frekanslı titreşmesiyle çalışır. Koagülasyon ve kesme işleminin aynı anda yapılmasına olanak sağlayarak diseksiyon kolaylığı sağlar. Bu çalışmanın amacı, total tiroidektomilerde HS kullanı-mının KT göre bir avantaj sağlayıp sağlamadığını araştırmaktır.
Gereç ve
ABSTRACTObjective: The aim of this study was to investigate whether the use of the Harmonic Scalpel (HS) provides advantages in total thyroidectomy compared with the conventional technique (CT).
Material and Methods:A total of 200 consecutive patients who underwent total thyroidectomy at the Department of General Surgery of the Akdeniz University Faculty of Medicine between 02.11.2009 and 21.07.2010 were included in the study. The patients were randomly divided into two groups. A total of 100 patients who underwent thyroidectomy using HS comprised the fi rst group and the remaining 100 patients who underwent thyroidectomy with the use of CT comprised the second group. The demographic data of the patients, operation and total anesthesia times, incision length, drainage amount, complication rate, and the FNAB (fi ne needle aspiration biopsy) and histopathology results of both groups were compared.Results: Operation and anesthesia times were found to be 16 minutes shorter in thyroidectomies performed using HS compared to the CT group (p<0.001). Transient and permanent nerve injuries, hypocalcemia and postoperative hemorrhage rates were not different between the groups.
Conclusion:The operation time was found to have shortened without changes in thyroidectomyrelated complication rates using HS in total thyroidectomy. Thus, we believe that the use of the Harmonic Scalpel is an effective and safe method in thyroid surgery.