Is Using the Harmonic Scalpel Better than Conventional Hemostasis in Neck Dissection? A Meta-Analysis.

Autor:	Hameed I; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Khan MO; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Samad SA; Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan., Mahmood S; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Siddiqui OM; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Hameed I; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Nashit M; Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan., Iqbal A; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Marsia S; Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan., Al Shetawi AH; Division of Oral and Maxillofacial Surgery, Vassar Brothers Medical Center, Poughkeepsie, NY, USA.
Jazyk:	angličtina
Zdroj:	Craniomaxillofacial trauma & reconstruction [Craniomaxillofac Trauma Reconstr] 2024 Mar; Vol. 17 (1), pp. 74-86. Date of Electronic Publication: 2023 Apr 15.
DOI:	10.1177/19433875231170924
Abstrakt:	Study Design: Systematic review and meta-analysis. Objective: The clinical decision to pursue harmonic scalpel (HS) method vs conventional hemostasis to treat head and neck cancers has been arguably predicated on the clinical outcomes observed. This study aims to evaluate the surgical outcomes of neck dissection between both techniques and perform an updated meta-analysis using the available literature. Methods: We searched PubMed, Scopus, and Cochrane Library through 31st December 2021, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome metrics included operative time and intraoperative blood loss. Secondary outcomes consisted of length of hospital stay, length of drain stay, total drain output, and postoperative complications. A meta-analysis was conducted using Review Manager Version 5.3 (RevMan) software employing the Random Effects Model. Results: We identified 114 articles, out of which 10 randomized control trials (RCTs) analyzing a combined total of 558 patients met the inclusion criteria after title and full-text screening. Meta-analysis shows the group treated with HS had a significantly shorter operative time. [MD = -23.21, 95% CI (-34.30, -12.12) P value <.0001 I 2 = 92%] but an insignificant lesser intraoperative blood loss [MD = -61.53, 95% CI (-88.61, -34.45) P < .00001 I 2 = 79%]. Conclusions: This study confirms that that HS use in neck dissection yields a reduced operative time and intra operative blood loss relative to conventional hemostasis. Furthermore, our paper shows no superiority of HS method over conventional hemostasis where length of hospital stays, length of drain stays, and postoperative complications are concerned. Future RCTs with high-level evidence may further elucidate the relative effectiveness of HS method over conventional hemostasis in treating head and neck cancers. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2023.)
Databáze:	MEDLINE
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