Abstract:Objective: To systematically evaluate the application value of ultrasonic scalpel in open thyroid surgery. Methods: The literature of randomized controlled trials (RCTs) concerning the use of ultrasonic scalpel in open thyroid surgery was retrieved by searching national and international databases. Data were screened and extracted according to the inclusion and exclusion criteria, and were statistically analyzed by using RevMan 5.2 analysis software. Results: Thirty RTCs were finally included, with a total of 1 527 patients. Meta-analysis results showed that compared with conventional surgery, usage of the ultrasonic scalpel reduced the operative time for either total thyroidectomy or thyroid lobectomy (WMD=–22.73, 95% CI=–29.15––16.32, P<0.00001; WMD=–16.21, 95% CI=–19.74––12.69, P<0.00001), decreased the intraoperative blood loss and postoperative drainage volume as well as the postoperative incidence of transient hypocalcemia in total thyroidectomy (WMD=–31.00, 95% CI=–38.85––23.15, P<0.00001; WMD=–12.56, 95% CI=–21.36––3.76, P=0.005; OR=0.59, 95% CI=0.42–0.83, P=0.003). No significant difference was noted in incidence of recurrent laryngeal nerve palsy between surgery with ultrasonic scalpel and conventional procedure (OR=1.38, 95% CI=0.70–2.74, P=0.35). Conclusion: The use of ultrasonic scalpel in open thyroid surgery can reduce the operative time, intraoperative blood loss, postoperative drainage volume and incidence of transient hypocalcemia.