BibTex RIS Kaynak Göster

Total Tiroidektomide Harmonic Scalpel Fayda Sağlıyor mu?

Yıl 2015, Cilt: 1 Sayı: 3, 130 - 136, 01.01.2015

Öz

Amaç: 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 kullanımının KT göre bir avantaj sağlayıp sağlamadığını araştırmaktır.Gereç ve Yöntemler: Akdeniz Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda, 02.11.2009 ve 21.07.2010 tarihleri arasında, total tiroidektomi yapılan ardışık 200 hasta çalışmaya alındı. Hastalar randomize olarak iki gruba ayrıldı. Birinci grupta HS kullanılarak tirodektomi yapılan 100 hasta, diğer ikinci grupta ise KT uygulanarak tiroidektomi yapılan 100 hasta yer aldı. Her iki grup arasında hastaların demografi k verileri, ameliyat ve toplam anestezi süreleri, insizyon uzunlukları, drenaj miktarları, komplikasyon oranları, İİAB ve histopatolojik sonuçları karşılaştırıldı.Bulgular: HS ile yapılan tiroidektomilerde, ameliyat süresinin ve anestezi süresinin KT grubuna göre 16 dk kısa olduğu görüldü p

Kaynakça

  • Duh QY. What’s new in general surgery: Endocrine surgery. J Am Coll Surg 2005; 201:746-53.
  • Ambrosi A, Fersini A, Samele F. Employment of new technologies in thyroid surgery. Langenbecks Arch Surg 2006; 391:47-8.
  • Shemen L. Thyroidectomy using the harmonic scalpel: Analysis of 105 consecutive cases. Otolaryngology- Head Neck Surg. 2002;127:284-8.
  • Karvounaris DC, Antonopoulos V, Psarras K, Sakadamis A. Effi cacy and safety of ultrasonically activated shears in thyroid surgery. Head Neck 2006; 28: 1028-31.
  • Sartori VP, Fina SD, Colombo G,Pugliese F, Romano F, Cesana G, Uggeri F. Ligasure versus Ultracision in thyroid surgery: A prospective randomized study. Langenbecks Arch Surg 2008; 393: 655-8.
  • Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: A randomized trial. Ann Surg 2000;231:322-8.
  • Defechereux T, Rinken F, Maweja S, Hemoir E, Meurisse M. Evaluation of the ultrasonic dissector in thyroid surgery. A prospective randomised study. Acta Chir Belg 2003;103:274-7.
  • Emam T, Cuschieri A. How safe is high-power ultrasonic dissection. Ann Surg 2002;237:186-91.
  • Siperstein A, Berber E, Morkoyun E. The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery. Arch Surg 2002;137(2):137-42.
  • Ortega J, Sala C, Flor B, Liedo S. Effi cacy and cost- effectiveness of the ultracision harmonic scalpel in thyroid surgery: An anaysis of 200 cases in a randomized trial. J Laparoendosc Adv Surg Tech A 2004 14:9-12.
  • Koutsoumanis K, Koutras AS, Drimousis P, Stamou KM, Theodorou D, Katsaragakis S, Bramis J. The use of a harmonic scalpel in thyroid surgery: Report of a 3-year experience. Am J Surg 2007; 193:693-6.
  • Cordón C, Fajardo R, Ramírez J, Herrera MF. A randomized, prospective, parallel group study comparing the harmonic scalpel to electrocautery in thyroidectomy. Surgery 2005; 137:337-41.
  • Marchesi M, Biffoni M, Cresti R, Mulas MM, Turriziani V, Berni A, Campana FP. Ultrasonic scalpel in thyroid surgery. Chir Ital 2003; 55(2):299-308.
  • Terris DJ, Seybt MW, Gourin CG, Chin E. Ultrasonic technology facilitates minimal access thyroid surgery. Laryngoscope 2006; 116:851-4.
  • Miccoli P, Berti P, Raffaelli M, Materrazi G, Conte M, Galleri D. Impact of harmonic scalpel on operative time during video-assisted thyroidectomy. Surg Endosc 2002; 16:663-6.
  • Mantke R, Pross M, Klose S, Lehnert H, Lİppert H. The harmonic scalpel in conventional thyroid surgery. Possibilities and advantages. Chirurg 2003; 74: 739- 42.
  • Yildirim O, Umit T, Ebru M, Unal B, Kocer B, Bozkurt B, Dolapci M, Cengiz O. Ultrasonic harmonic scalpel in total thyroidectomies. Adv Ther 2008;25(3):260-5.
  • Lombardi PC, Raffaelli M, Cicchetti A, Marchetti M, De Crea C, Di Bidino R, Oragano L, Bellantone R. The use of “harmonic scalpel” versus “knot tying” for conventional “open” thyroidectomy: Results of a prospective randomized study. Langenbecks Arch Surg 2008; 393:627-31.
  • Parker DJ, Krupa K, Esler R, Vujovic P, Bennett IC. Use of the harmonic scalpel in thyroidectomy. ANZ J Surg 2009; 79: 476-80.
  • Hallgrimsson P, Loven L, Westerdahl J, Brgenfelz A. Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: A prospective randomised controlled trial. Langenbecks Arch Surg 2008; 393:675-80.
  • Kilic M, Keskek M, Ertan T, Yoldas O, Bilgin A, Koc M. A prospective randomized trial comparing the harmonic scalpel with conventional knot tying in thyroidectomy. Adv Ther 2007; 24: 632-8.
  • Miccoli P, Berti P, Dionigi Gian L, D’Agostino J, Orlandini C, Donatini G. Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 2006; 132:1069-73.
  • Boger MS, Perrier ND. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism. Surg Clin N Am 2004; 84 (3): 849-74.
  • Muller PE, Kabus S, Robens E, Spelsberg F. Indications, risks and acceptance of total thyroidectomy for multinodular benign goiter. Surg Today 2001; 31: 958- 62.
  • Gough IR, Wilkinson D. Total; thyroidectomy for management of thyroid disease. World J Surg 2000; 24: 962-5.
  • Liu Q, Djuricin G, Prinz RA. Total thyroidectomy for management of thyroid disease. Surgery 1998; 123: 2-7.
  • Husein M, Hier MP, Al-Abdulhadi K, Black M. Predicting calcium status postthyroidectomy with early calcium levels. Otolaryngol Head Neck Surg 2002; 127 (4): 289-93.
  • Glinoer D, Andry G, Chantrain G, Samil N. Clinical aspects of early and late hypocalcemia after thyroid surgery. Eur J Surg Oncol 2000; 26 (6): 571-7.

Is Harmonic Scalpel Benefi cial in Total Thyroidectomy?

Yıl 2015, Cilt: 1 Sayı: 3, 130 - 136, 01.01.2015

Öz

Objective: 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

Kaynakça

  • Duh QY. What’s new in general surgery: Endocrine surgery. J Am Coll Surg 2005; 201:746-53.
  • Ambrosi A, Fersini A, Samele F. Employment of new technologies in thyroid surgery. Langenbecks Arch Surg 2006; 391:47-8.
  • Shemen L. Thyroidectomy using the harmonic scalpel: Analysis of 105 consecutive cases. Otolaryngology- Head Neck Surg. 2002;127:284-8.
  • Karvounaris DC, Antonopoulos V, Psarras K, Sakadamis A. Effi cacy and safety of ultrasonically activated shears in thyroid surgery. Head Neck 2006; 28: 1028-31.
  • Sartori VP, Fina SD, Colombo G,Pugliese F, Romano F, Cesana G, Uggeri F. Ligasure versus Ultracision in thyroid surgery: A prospective randomized study. Langenbecks Arch Surg 2008; 393: 655-8.
  • Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: A randomized trial. Ann Surg 2000;231:322-8.
  • Defechereux T, Rinken F, Maweja S, Hemoir E, Meurisse M. Evaluation of the ultrasonic dissector in thyroid surgery. A prospective randomised study. Acta Chir Belg 2003;103:274-7.
  • Emam T, Cuschieri A. How safe is high-power ultrasonic dissection. Ann Surg 2002;237:186-91.
  • Siperstein A, Berber E, Morkoyun E. The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery. Arch Surg 2002;137(2):137-42.
  • Ortega J, Sala C, Flor B, Liedo S. Effi cacy and cost- effectiveness of the ultracision harmonic scalpel in thyroid surgery: An anaysis of 200 cases in a randomized trial. J Laparoendosc Adv Surg Tech A 2004 14:9-12.
  • Koutsoumanis K, Koutras AS, Drimousis P, Stamou KM, Theodorou D, Katsaragakis S, Bramis J. The use of a harmonic scalpel in thyroid surgery: Report of a 3-year experience. Am J Surg 2007; 193:693-6.
  • Cordón C, Fajardo R, Ramírez J, Herrera MF. A randomized, prospective, parallel group study comparing the harmonic scalpel to electrocautery in thyroidectomy. Surgery 2005; 137:337-41.
  • Marchesi M, Biffoni M, Cresti R, Mulas MM, Turriziani V, Berni A, Campana FP. Ultrasonic scalpel in thyroid surgery. Chir Ital 2003; 55(2):299-308.
  • Terris DJ, Seybt MW, Gourin CG, Chin E. Ultrasonic technology facilitates minimal access thyroid surgery. Laryngoscope 2006; 116:851-4.
  • Miccoli P, Berti P, Raffaelli M, Materrazi G, Conte M, Galleri D. Impact of harmonic scalpel on operative time during video-assisted thyroidectomy. Surg Endosc 2002; 16:663-6.
  • Mantke R, Pross M, Klose S, Lehnert H, Lİppert H. The harmonic scalpel in conventional thyroid surgery. Possibilities and advantages. Chirurg 2003; 74: 739- 42.
  • Yildirim O, Umit T, Ebru M, Unal B, Kocer B, Bozkurt B, Dolapci M, Cengiz O. Ultrasonic harmonic scalpel in total thyroidectomies. Adv Ther 2008;25(3):260-5.
  • Lombardi PC, Raffaelli M, Cicchetti A, Marchetti M, De Crea C, Di Bidino R, Oragano L, Bellantone R. The use of “harmonic scalpel” versus “knot tying” for conventional “open” thyroidectomy: Results of a prospective randomized study. Langenbecks Arch Surg 2008; 393:627-31.
  • Parker DJ, Krupa K, Esler R, Vujovic P, Bennett IC. Use of the harmonic scalpel in thyroidectomy. ANZ J Surg 2009; 79: 476-80.
  • Hallgrimsson P, Loven L, Westerdahl J, Brgenfelz A. Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: A prospective randomised controlled trial. Langenbecks Arch Surg 2008; 393:675-80.
  • Kilic M, Keskek M, Ertan T, Yoldas O, Bilgin A, Koc M. A prospective randomized trial comparing the harmonic scalpel with conventional knot tying in thyroidectomy. Adv Ther 2007; 24: 632-8.
  • Miccoli P, Berti P, Dionigi Gian L, D’Agostino J, Orlandini C, Donatini G. Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 2006; 132:1069-73.
  • Boger MS, Perrier ND. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism. Surg Clin N Am 2004; 84 (3): 849-74.
  • Muller PE, Kabus S, Robens E, Spelsberg F. Indications, risks and acceptance of total thyroidectomy for multinodular benign goiter. Surg Today 2001; 31: 958- 62.
  • Gough IR, Wilkinson D. Total; thyroidectomy for management of thyroid disease. World J Surg 2000; 24: 962-5.
  • Liu Q, Djuricin G, Prinz RA. Total thyroidectomy for management of thyroid disease. Surgery 1998; 123: 2-7.
  • Husein M, Hier MP, Al-Abdulhadi K, Black M. Predicting calcium status postthyroidectomy with early calcium levels. Otolaryngol Head Neck Surg 2002; 127 (4): 289-93.
  • Glinoer D, Andry G, Chantrain G, Samil N. Clinical aspects of early and late hypocalcemia after thyroid surgery. Eur J Surg Oncol 2000; 26 (6): 571-7.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Barış Özcan Bu kişi benim

Ayhan Mesci Bu kişi benim

Taner Çolak Bu kişi benim

Muhittin Yaprak Bu kişi benim

Kenan Güney Bu kişi benim

Nezihi Oygur Bu kişi benim

Cumhur Arıcı Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 1 Sayı: 3

Kaynak Göster

APA Özcan, B., Mesci, A., Çolak, T., Yaprak, M., vd. (2015). Total Tiroidektomide Harmonic Scalpel Fayda Sağlıyor mu?. Akdeniz Tıp Dergisi, 1(3), 130-136.