Comparative Effectiveness and Safety of Energy Devices for Thyroidectomy: An Outcome-Specific Network Meta-Analysis of Randomized Controlled Trials
In brief
Harmonic devices cut postoperative bleeding odds by 44% versus conventional hemostasis
In a network meta-analysis of randomized trials, Harmonic devices also reduced operative time, blood loss, hospital stay, and odds of transient hypocalcemia and vocal cord nerve palsy compared with conventional hemostasis. LigaSure improved operative efficiency, but its other benefits were less consistent. The comparisons do not establish overall device superiority, so absolute benefits and device characteristics still matter.
- Journal
- Head & neck (Q1)
- Published
- 27 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Do Hyun Kim, David W Jang, Se Hwan Hwang
- PMID
- 42947529
- DOI
- 10.1002/hed.70524
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 29 October 2026): Randomized-trial synthesis compares devices used in thyroidectomy
Abstract
BACKGROUND: We performed an outcome-specific network meta-analysis comparing contemporary energy devices in thyroidectomy. METHODS: Randomized controlled trials comparing conventional hemostasis with Harmonic, LigaSure, Thunderbeat, or other advanced energy devices during thyroidectomy were included. Frequentist random-effects network meta-analyses were performed per outcome, with treatments ranked by P-scores and consistency assessed via design-by-treatment interaction and node-splitting analyses. RESULTS: Compared to conventional hemostasis, Harmonic significantly reduced operative time (SMD, -1.88), blood loss (SMD, -2.29), drainage volume (SMD, -1.77), hospital stay (SMD, -0.74), transient hypocalcemia (OR, 0.61), transient recurrent laryngeal nerve palsy (OR, 0.63), and postoperative bleeding (OR, 0.56). LigaSure improved operative efficiency but showed less consistent recovery and safety benefits. Harmonic ranked highest across most outcomes. CONCLUSIONS: Harmonic showed the most favorable relative effects across the evaluated outcomes. However, these findings do not establish overall device superiority; selection should consider absolute benefits and device-specific characteristics.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.