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. Keywords: Thyroidectomy, Harmonic, Conventional and Bleeding control. DOI : 10.7176/JMPB/54-09 Publication date : April 30 th 2019
Highlights
The description about the thyroid gland is very prehistoric’ for the first time it was name as “shield shape gland” by the Romans[1]
On other hand modern techniques involve harmonic scalpel and thyroidectomy The only change that has brought in this mechanism is only the choice of certain type of operation i.e. lobectomy, total thyroidectomy, subtotal thyroidectomy for a given diagnosis
Many studies has conducted in the past, but almost no one study shows that conventional knot method is better comparative to harmonic but recent studies done with highly advanced technology shows that harmonic scalpel is much better than ligation[12]
Summary
The description about the thyroid gland is very prehistoric’ for the first time it was name as “shield shape gland” by the Romans[1]. 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 controlled by ligatures[4]. Some other methods related to this are nerve stimulation, and hypnosis for anesthesia. All these are not widely accepted[5]
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