The No-Tie Technique Using the Harmonic Scalpel in Total Thyroidectomy With Central Neck Dissection: A Prospective Randomized Study

Inclusion Criteria: * patients with total thyroidectomy plus central neck dissection * if primary tumor size was more than 1 cm in papillary thyroid cancer * there was any evidence of lymph node enlargement in paratracheal lymph node group preoperatively or intraoperatively * patients who underwent minimal resection of the surrounding soft tissues, including the sternothyroid or sternohyoid muscle, for extracapsular extension of thyroid cancer Exclusion Criteria: * patients who required lateral compartment neck dissection or mediastinal dissection for preexisting lymph node metastasis * patients had clinical or laboratory indicators of coagulation disorders * patients with preexisiting vocal cord palsy, fixation of the tumor to the recurrent laryngeal nerve requiring trnasection of the nerve * patients with massive extracapsular extension to the surrounding soft tissues.