Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial
Identifieur interne : 000929 ( Pmc/Checkpoint ); précédent : 000928; suivant : 000930Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial
Auteurs : Dieter K. Fritz [Canada] ; T. Wayne Matthews [Canada] ; Shamir P. Chandarana [Canada] ; Steven C. Nakoneshny [Canada] ; Joseph C. Dort [Canada]Source :
- Journal of Otolaryngology - Head & Neck Surgery [ 1916-0208 ] ; 2016.
Abstract
Long 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).
Thirty-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.
Mean blood loss in the experimental group was 260 mL versus 403 mL in the control group (
In 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.
ClinicalTrials.gov,
Url:
DOI: 10.1186/s40463-016-0173-z
PubMed: 27821144
PubMed Central: 5100249
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial</title><author><name sortKey="Fritz, Dieter K" sort="Fritz, Dieter K" uniqKey="Fritz D" first="Dieter K." last="Fritz">Dieter K. Fritz</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Matthews, T Wayne" sort="Matthews, T Wayne" uniqKey="Matthews T" first="T. Wayne" last="Matthews">T. Wayne Matthews</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Chandarana, Shamir P" sort="Chandarana, Shamir P" uniqKey="Chandarana S" first="Shamir P." last="Chandarana">Shamir P. Chandarana</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Nakoneshny, Steven C" sort="Nakoneshny, Steven C" uniqKey="Nakoneshny S" first="Steven C." last="Nakoneshny">Steven C. Nakoneshny</name><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Dort, Joseph C" sort="Dort, Joseph C" uniqKey="Dort J" first="Joseph C." last="Dort">Joseph C. Dort</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27821144</idno><idno type="pmc">5100249</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100249</idno><idno type="RBID">PMC:5100249</idno><idno type="doi">10.1186/s40463-016-0173-z</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D71</idno><idno type="wicri:Area/Pmc/Curation">000D70</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D70</idno><idno type="wicri:Area/Pmc/Checkpoint">000929</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000929</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial</title><author><name sortKey="Fritz, Dieter K" sort="Fritz, Dieter K" uniqKey="Fritz D" first="Dieter K." last="Fritz">Dieter K. Fritz</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Matthews, T Wayne" sort="Matthews, T Wayne" uniqKey="Matthews T" first="T. Wayne" last="Matthews">T. Wayne Matthews</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Chandarana, Shamir P" sort="Chandarana, Shamir P" uniqKey="Chandarana S" first="Shamir P." last="Chandarana">Shamir P. Chandarana</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Nakoneshny, Steven C" sort="Nakoneshny, Steven C" uniqKey="Nakoneshny S" first="Steven C." last="Nakoneshny">Steven C. Nakoneshny</name><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Dort, Joseph C" sort="Dort, Joseph C" uniqKey="Dort J" first="Joseph C." last="Dort">Joseph C. Dort</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</nlm:aff><orgName type="university">Université de Calgary</orgName><country>Canada</country><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author></analytic><series><title level="j">Journal of Otolaryngology - Head & Neck Surgery</title><idno type="ISSN">1916-0208</idno><idno type="eISSN">1916-0216</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Long operating time and high blood loss contribute to post-surgical morbidity. Therefore, strategies to reduce these factors should to be tested using robust methods.</p><p>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).</p></sec><sec><title>Methods</title><p>Thirty-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.</p></sec><sec><title>Results</title><p>Mean blood loss in the experimental group was 260 mL versus 403 mL in the control group (<italic>p</italic> = 0.08). Mean operative time was 140 min in the experimental group and 159 min in the control group (<italic>p</italic> = 0.2).</p></sec><sec><title>Conclusions</title><p>In 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.</p></sec><sec><title>Trial registration</title><p>ClinicalTrials.gov, <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/show/NCT02017834">NCT02017834</ext-link>.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Parkin, D" uniqKey="Parkin D">D Parkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aramaki, O" uniqKey="Aramaki O">O Aramaki</name></author><author><name sortKey="Takayama, T" uniqKey="Takayama T">T Takayama</name></author><author><name sortKey="Higaki, T" uniqKey="Higaki T">T 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Otolaryngol Head Neck Surg</journal-id><journal-id journal-id-type="iso-abbrev">J Otolaryngol Head Neck Surg</journal-id><journal-title-group><journal-title>Journal of Otolaryngology - Head & Neck Surgery</journal-title></journal-title-group><issn pub-type="ppub">1916-0208</issn><issn pub-type="epub">1916-0216</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27821144</article-id><article-id pub-id-type="pmc">5100249</article-id><article-id pub-id-type="publisher-id">173</article-id><article-id pub-id-type="doi">10.1186/s40463-016-0173-z</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research Article</subject></subj-group></article-categories><title-group><article-title>Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Fritz</surname><given-names>Dieter K.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Matthews</surname><given-names>T. Wayne</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Chandarana</surname><given-names>Shamir P.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Nakoneshny</surname><given-names>Steven C.</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Dort</surname><given-names>Joseph C.</given-names></name><address><phone>(403) 220-4307</phone><email>jdort@ucalgary.ca</email><uri>http://www.ohlsonresearch.ca</uri></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><aff id="Aff1"><label>1</label>Department of Surgery, Section of Otolaryngology – Head & Neck Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6 Canada</aff><aff id="Aff2"><label>2</label>Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada</aff></contrib-group><pub-date pub-type="epub"><day>8</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>8</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>45</volume><elocation-id>58</elocation-id><history><date date-type="received"><day>6</day><month>8</month><year>2016</year></date><date date-type="accepted"><day>1</day><month>11</month><year>2016</year></date></history><permissions><copyright-statement>© The Author(s). 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Long operating time and high blood loss contribute to post-surgical morbidity. Therefore, strategies to reduce these factors should to be tested using robust methods.</p><p>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).</p></sec><sec><title>Methods</title><p>Thirty-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.</p></sec><sec><title>Results</title><p>Mean blood loss in the experimental group was 260 mL versus 403 mL in the control group (<italic>p</italic> = 0.08). Mean operative time was 140 min in the experimental group and 159 min in the control group (<italic>p</italic> = 0.2).</p></sec><sec><title>Conclusions</title><p>In 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.</p></sec><sec><title>Trial registration</title><p>ClinicalTrials.gov, <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/show/NCT02017834">NCT02017834</ext-link>.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Oral cancer</kwd><kwd>Harmonic scalpel</kwd><kwd>Head and neck squamous cell carcinoma</kwd><kwd>Randomized clinical trial</kwd><kwd>Health technology assessment</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Canada</li></country><region><li>Alberta</li></region><settlement><li>Calgary</li></settlement><orgName><li>Université de Calgary</li></orgName></list><tree><country name="Canada"><region name="Alberta"><name sortKey="Fritz, Dieter K" sort="Fritz, Dieter K" uniqKey="Fritz D" first="Dieter K." last="Fritz">Dieter K. Fritz</name></region><name sortKey="Chandarana, Shamir P" sort="Chandarana, Shamir P" uniqKey="Chandarana S" first="Shamir P." last="Chandarana">Shamir P. Chandarana</name><name sortKey="Chandarana, Shamir P" sort="Chandarana, Shamir P" uniqKey="Chandarana S" first="Shamir P." last="Chandarana">Shamir P. Chandarana</name><name sortKey="Dort, Joseph C" sort="Dort, Joseph C" uniqKey="Dort J" first="Joseph C." last="Dort">Joseph C. Dort</name><name sortKey="Dort, Joseph C" sort="Dort, Joseph C" uniqKey="Dort J" first="Joseph C." last="Dort">Joseph C. Dort</name><name sortKey="Matthews, T Wayne" sort="Matthews, T Wayne" uniqKey="Matthews T" first="T. Wayne" last="Matthews">T. Wayne Matthews</name><name sortKey="Matthews, T Wayne" sort="Matthews, T Wayne" uniqKey="Matthews T" first="T. Wayne" last="Matthews">T. Wayne Matthews</name><name sortKey="Nakoneshny, Steven C" sort="Nakoneshny, Steven C" uniqKey="Nakoneshny S" first="Steven C." last="Nakoneshny">Steven C. Nakoneshny</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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