Abstract
BackgroundLong operating time and high blood loss contribute to post-surgical morbidity. Therefore, strategies to reduce these factors should to be tested using robust methods.The purpose of this study was to evaluate the impact of using the harmonic scalpel on operating time and blood loss in patients undergoing resection for advanced oral cancer (OSCC).MethodsThirty-six adult head and neck cancer patients with advanced OSCC requiring primary tumor resection with uni- or bi- lateral selective neck dissection from July 2012 to September 2014 were randomized to either the control group (traditional surgery) or the experimental group (harmonic surgery). Patients older than 18 years who were able to provide informed consent were eligible. Primary outcomes of interest were: intraoperative blood loss (mL) and operative time (minutes) for the ablative part of the surgery.ResultsMean blood loss in the experimental group was 260 mL versus 403 mL in the control group (p = 0.08). Mean operative time was 140 min in the experimental group and 159 min in the control group (p = 0.2).ConclusionsIn this randomized controlled trial, use of the harmonic scalpel did not effect intraoperative blood loss or OR time in patients undergoing surgery for advanced OSCC.Trial registrationClinicalTrials.gov, NCT02017834.
Highlights
Long operating time and high blood loss contribute to post-surgical morbidity
All patients enrolled in the study underwent resection of an advanced Oral squamous cell cancer (OSCC) in addition to a unilateral or bilateral selective neck dissection (SND)
The groups were homogeneous for age, sex, body mass index (BMI), TNM staging and comorbidity
Summary
Long operating time and high blood loss contribute to post-surgical morbidity. The purpose of this study was to evaluate the impact of using the harmonic scalpel on operating time and blood loss in patients undergoing resection for advanced oral cancer (OSCC). Oral squamous cell cancer (OSCC) is among the top ten most prevalent malignancies affecting patients worldwide [1]. Treatment consists of a multidisciplinary approach involving the head and neck surgeon, radiation oncologist and medical oncologist. Surgical resection is the primary treatment of OSCC and can involve both complex resection and reconstruction. Surgical blood loss and prolonged operating time adversely impact treatment outcomes in a variety of surgical procedures including major head and neck surgery [2,3,4,5]. The HS has been adapted for use in a broad range
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