Comparison study between the usage of harmonic scalpel versus classical suture method for thyroidectomy in Iraqi patients.

Objective: To compare the outcome of harmonic scalpel use in thyroid surgery versus conventional suture method in a sample of Iraqi patients.

Methods: A prospective, comparative, interventional study with analytic elements was conducted on 76 patients complaining of different types of goitre attending Al-Yarmouk Teaching Hospital, Baghdad, from October 2017 to October 2019. Patients were divided into two groups, a test group including 25 patients operated upon by harmonic scalpel and the control group of 51 patients who underwent conventional suture ligation. Informed consent was obtained from all patients after explaining the procedure. The necessary investigations were done preoperatively with anaesthetic consultation. After surgery, type of thyroidectomy (Total, near total, subtotal, lobectomy), time of surgery, the results of the postoperative checkup including vital signs, voice state, any stridor or dyspnoea, drains (amount drained) and signs of hypocalcaemia were noted.

Results: The 76 patients were divided into 2 groups. Most of the patients were female (61 females, 23 in harmonic & 38 in conventional group" Vs. 15 males, 2 in harmonic & 13 in conventional group). The mean ages in both groups were comparable. The mean age was 40.0±9.7 years for conventional suture ligation group with females being 39.7±10.3 years and males being 40.8±7.9 years old. The mean age of patients in the harmonic scalpel group was 40.5±11.7 years with females being 40.4±12.5 years old and males 42.0±1.0 of age. Most of the HS devise patients had thyrotoxic goiter in comparison to simple goiter in the control group. The study shows a significant reduction in the time of surgery in the harmonic scalpel group, therefore most of them showed a significant reduction in the amount of blood in their drain and the drain was removed within 24 hours. Regarding the remaining post-operative complications like bleeding, stridor, and recurrent laryngeal nerve injury. The results had no statistical significant difference in both groups.

Conclusions: Both HS and ligation sutures were effective in thyroid surgery except the reduction in operation time and postoperative drainage in the HS group. Both techniques were taken as reasonably safe procedures.