EFFICACY OF ULTRASONIC SCALPEL USE IN SUBMANDIBULAR GLAND SIALOADENECTOMY
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Abstract
Background The conventional surgical methods use clamping and ligation of blood vessels to stop bleeding during submandibular salivary gland tumor surgery. There is some risk of complications such as injury to the 7th cranial nerve, sialocele and salivary fistula, which causing the prolongation hospital length of stay. Submandibular gland sialoadenectomy needs methods that completed with meticulous technique to avoid vascular and nerve injury. Ultrasonic scalpel, using ultrasonic frictional heating to ligate vessels and separate tissue, tends to be faster, cause less trauma, and lower bleeding.
Objective To compare the outcomes of the submandibular gland surgery using conventional surgical method and ultrasonic scalpel.
Methods We conducted a retrospective cohort study on patients undergoing unilateral submandibular gland surgery from October 2016 to April 2021. Patients were divided into two groups: 1) using the conventional technique (clamping and tying the vessels) and 2) using an ultrasonic scalpel.
Results A total of 14 patients were included: 5 patients in conventional technique group and 9 patients in ultrasonic scalpel-used group. When performing multivariable regression analysis, the results of treatment were better among patients in the ultrasonic scalpel-used group.
These included having less intraoperative bleeding (p 0.001), less the total amount of drainage (p 0.030) and tended to have earlier drain removal (p. 0.135). There was not significantly different in surgical duration and the pain level of the patients. And no surgical complication found in all patients.
Conclusion and Recommendation This study shows the favorable outcomes obtained by the use of an ultrasonic scalpel for salivary gland resection. This should result in the reduction of hospital length of stay and it is an opportunity for the quality improvement of patient care.
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