Compare Bipolar Diathermy and Suture Ligation for Hemostasis in Tonsilectomy in Terms of the Amount of Blood Loss

Abstract

Objective: The purpose of our study is to compare the outcomes in terms of blood loss, post-operative hemorrhage and operative time between bipolar diathermy and suture ligation for hemostasis in tonsillectomy. Study Design: Randomized Control trial Place and Duration: The study was conducted at ENT department of Peshawar Medical College Peshawar and Chaudhary Muhammad Akram Teaching and Research Hospital Lahore during the period from February 2020 to July 2020. Methods: There were ninety four patients of both genders with ages 5-40 years were presented. Included patients had chronic tonsillitis. After obtaining informed permission, the recruited patients' demographic data, including their age and gender, was recoded. Patients were equally categorized in two groups. Group I had 47 patients and received bipolar diathermy and group II received suture ligation among 47 cases. Outcomes among both groups were calculated and compared in terms of operative time, blood loss and post-operative complications. SPSS 25.0 version was used to analyze complete data. Results: Majority of the patients were males 55 (58.5%) and the rest were females 39 (41.5%) in study. In patients of bipolar diathermy mean age were 14.11±4.55 years while in group II mean age was 13.32±6.49 years. Number of left side tonsils in group I was among 25 (53.2%) patients and in group II left tonsils found in 30 (63.8%) cases. Mean operative time in group I was lower 11.9±8.88 minutes as compared to group II 15.4±4.35 minutes with p value <0.03. Mean blood loss in group II was significantly higher 40.15±7.71 mL as compared to group I 25.4±6.42 mL with p value <0.04. There was no any case found of post-operative hemorrhage in both groups. Frequency of ligatures among group I was 2 (4.3%) significantly lower than group II in 45 (95.7%) cases. Conclusion: We concluded in this study that the use of bipolar diathermy for hemostasis in tonsillectomy was beneficial and efficient in terms of less operative time with less blood loss as compared to suture ligation technique. Except this both technique are beneficial in term of post-operative hemorrhage which was not observed in both groups. Keywords: Bipolar Diathermy, Hemostasis Tonsillectomy, Suture Ligation, Hemorrhage, Blood Loss