A comparative study between coblation and bipolar electrocautery tonsillectomy in children

Abstract

Introduction Tonsillectomy is one of the most common surgical procedures performed in the ear, nose, and throat (ENT) practice. 1 Over the last few years, different techniques for performing tonsillectomy have been proposed as attempts to lower the inherent morbidity of this surgery. 2 These techniques include blunt cold steel dissection, guillotine excision, monopolar diathermy, bipolar diathermy, laser dissection, bipolar scissor dissection and recently coblation tonsillectomy. 3 Any new tonsillectomy procedure needs to be comparable, or even better than present technique in terms of morbidity, mortality, safety of use, short learning curve, and cost-effectiveness. It should also be associated with less postoperative pain and intraoperative blood loss, and result in a more rapid return to normal diet and activity and carry a lower risk of both reactive and secondary hemorrhage. 4 There is still controversy over which is the optimal technique of tonsillectomy with the lowest morbidity rates. 5 In contrast to the majority of operative procedures associated with primary wound closure, Background and objective: Tonsillectomy with or without adenoidectomy is an operation done frequently in all otolaryngology departments all over the world. Many new surgical techniques found over the last few decades to decrease the morbidity of this surgery. This study aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy. Methods: This prospective study was carried out on 60 patients that underwent tonsillectomy over six months from 1(st) August 2014 to 31(st) January 2015 in Rizgary Teaching Hospital, Erbil city. They patients equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 2.5-12 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding. Results: There was no statistically significant difference in the mean operation time between the coblation group and bipolar electrocautery group (6.89 min vs. 7.83 min, P = 0.11). The mean intraoperative blood loss was statistically lower for the bipolar electrocautery group versus the coblation group (1.43 ml vs. 15.37 ml, P <0.001). There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. No episodes of primary or secondary hemorrhage were recorded. Conclusion: Bipolar electrocautery tonsillectomy offers the same operative speed, less intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.

Coblation versus Bipolar Diathermy Hemostasis in Pediatric Tonsillectomy Patients: Systematic Review and Meta-Analysis

“…A more recent study in Iraq 26 , which compared intraoperative efficiency and postoperative recovery between bipolar electrocautery and coblation tonsillectomy in children, recorded statistically and clinically significant higher amounts of intra-operative blood loss in bipolar technique than using coblation (Bipolar 1.43 ml vs. Coblation 15.37 ml, P <0.001). Although this outcome conflicts with the results of this study, the coblation technique was associated with lower mean pain scores, which is the direction of this study 26 .…”

Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

“…In Iraq, few randomized controlled trials studied the comparison between the cold steel dissection method with CO2 laser (19), coblation and bipolar diathermy (12), and coblation versus dissection method (20).…”

Coblation Versus Bipolar Diathermy Hemostasis in Pediatric Tonsillectomy Patients: Systematic Review and Meta-Analysis

“…A more recent study in Iraq [ 26 ], which compared intraoperative efficiency and post-operative recovery between bipolar electrocautery and coblation tonsillectomy in children, recorded statistically and clinically significant higher amounts of intra-operative blood loss in bipolar technique than using coblation (Bipolar 1.43 ml vs. Coblation 15.37 ml, P <0.001). Although this outcome conflicts with the results of this study, the coblation technique was associated with lower mean pain scores, which is the direction of this study [ 26 ].…”