Evidencia y recomendación. ¿Harmonic Ultracision ofrece ventajas en tiroidectomía?

Abstract

Introduction and objective: In a patient with thyroid disease [patient] undergoing thyroidectomy [intervention] is the technique performed with Harmonic Ultracision Focus® (HU) compared with conventional techniques (ligation, mono or bipolar electrocoagulation and Ligasure®) [comparison] safer [outcome]? Material and Methods: Literature search in PubMed databases, Cochrane Library and Scopus with the search strategy "(((((ultrasonic scalpel) OR harmonic)) AND thyroidectomy)) AND meta-analysis" was made. Results: Level of Evidence: Evidence of the advantage of using HU in thyroidectomy compared to other techniques is high on disposal of sutures, facilitating access to smaller spaces, reducing surgical time, reducing intraoperative and postoperative bleeding, reducing of transient hypoparathyroidism, reducing postoperative pain, reducing hospital stay and reducing costs. Conclusions: Recommendation: The recommendation of the use of HU in thyroidectomy facing other alternatives (conventional surgery / Ligasure®) is weak in favor because it reduces the incidence of laryngeal paralysis and is strongly in favor because it reduces operating time, intraoperative bleeding and postoperative drainage volumen. It also reduces the incidence of hypocalcemia, hospital staying and costs. The recommendation of the use of HU in thyroidectomy is strongly in favor.