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CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(04): e702-e707
DOI: 10.1055/s-0044-1779010
Systematic Review

Neck Dissection with Harmonic Instruments and Electrocautery: A Systematic Review

Rogério Aparecido Dedivitis
1   Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
2   Department of Head and Neck Surgery, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
,
Leandro Luongo de Matos
1   Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
3   Instituto do Câncer do Estado de São Paulo (ICESP), SP, Brazil
,
Mario Augusto Ferrari Castro 
4   Universidade Metropolitana de Santos, Medicine School, Santos, SP, Brazil
,
Sílvia Migueis Picado Petrarolha
1   Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
,
Luiz Paulo Kowalski
1   Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND).

Objective To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis.

Methods A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection.

Results There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS.

Conclusion The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.

Keywords

neck dissection - surgical hemostasis - squamous cell carcinoma - meta-analysis


Publication History

Received: 26 February 2023

Accepted: 26 November 2023

Article published online:
05 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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