Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

Salam, Abdus; Alam, Mahbub; Ahmed, Rezwan; Mahmud, Sultan

doi:10.3329/kyamcj.v10i1.41478

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…Further studies also contradict our results, where in each study the highest haemorrhage rate was presented after using different hot/electrocautery methods (monopolar/bipolar forceps), as shown by Brown et al ( 10 ), Pang et al ( 11 ) and Yilmaz et al ( 12 ). Alam et al ( 13 ) and Haddow et al ( 14 ) reported that there was no influence of the surgical technique on the post-tonsillectomy haemorrhage rate, and therefore contradict our results as well.…”

Section: Discussioncontrasting

confidence: 94%

Haemorrhage Rates After Two Commonly Used Tonsillectomy Methods: a Multicenter Study

Brkic¹,

Mujic²,

Softic³

et al. 2017

Med Arch

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Introduction:Tonsillectomy is a frequently used, low-risk surgical procedure. The post-tonsillectomy haemorrhage occurs rarely, but is a life-threatening complication. Some studies show that the surgical technique affects the haemorrhage rate.Aims:To analyse the post-tonsillectomy haemorrhage rate, and to determine whether the effect of the surgical technique on the haemorrhage rate exists.Methods:We retrospectively reviewed data of all patients who underwent a tonsillectomy in three regional ENT departments in Bosnia and Herzegovina (Tuzla, Zenica and Bihac) between January 1st 2015 and October 31st 2016. Disorders which could affect the post-tonsillectomy haemorrhage rate were excluded. Tonsillectomy techniques used in these three centers were the hot technique (monopolar/bipolar forceps dissection and haemostasis) and the combined technique (cold steel dissection with monopolar/bipolar forceps haemostasis).Results:1087 patients that underwent a tonsillectomy were analysed in this study. 864 (79.48%) of those were children. 922 (84.82%) patients were operated using the combined technique, 165 (15.17%) underwent a tonsillectomy using the hot technique. Post-tonsillectomy haemorrhage occured in 46 (4.23%) patients. 45 (4.88%) patients had a postoperative haemorrhage after tonsillectomy using the combined technique, whereas haemorrhage occured in 1 patient (0.6%) after using the hot technique. The haemorrhage rate was about eight times lower after tonsillectomy using the hot technique (p=0.012).Conclusion:We conclude that the surgical technique used for tonsillectomy and adenotonsillectomy with the lowest post-tonsillectomy haemorrhage rate is the hot technique; these results are statistically significant. This technique should be used whenever possible, in order to lower the risk of post-tonsillectomy haemorrhage.

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Section: Discussioncontrasting

confidence: 94%

Haemorrhage Rates After Two Commonly Used Tonsillectomy Methods: a Multicenter Study

Brkic¹,

Mujic²,

Softic³

et al. 2017

Med Arch

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“…Duration of surgery was 10.6 ± 0.4 minutes in group A and 17.0 ± 0.7 minutes in group B and the p-value was significant i.e. p <0.05 9 . No significant difference was observed for postoperative pain between cold steel dissection and monopolar cautery method 10 .…”

Section: Discussionmentioning

confidence: 82%

“…1: cold dissection with snare/dissector and 2: electrocautery methods. 4 First-time tonsillectomy was described by Celsius in the first century A.D. In the dissection method, tonsils are removed mechanically and hemostasis by the ligature (silk 1/0) or minimally used electrocautery to the bleeding points, and still, this method is the most popular method 5 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Complications after Tonsillectomy between Conventional Cold Steel Dissections Method and Electrocautery Tonsillectomy Method. A Randomized Controlled Trial

Khan¹,

Ibrahim²,

Rana³

et al. 2022

PJMHS

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Aims: To compare the intra-operative bleeding amount during the tonsillectomy operative procedure by using the monopolar electrocautery method versus the cold steel tonsillar dissector method, and to compare postoperative pain for the initial six hours in both groups. Study design: A randomized controlled trial Place and Duration: Departments of ORL (Otorhinolaryngology) and HNS, Kulsumbai Valika Social Security SITE Hospital, Karachi, and in Social Security Landhi Hospital Karachi, Pakistan from January 1st, 2021 to December 31st, 2021 Methodology: One hundred and twenty patients were selected for this study from the outpatient department of both hospitals and they were divided into two groups equally i.e. those patients who will be operated with monopolar electrocautery, included in group C and those patients who will be operated on with the cold steel dissection method by tonsillar dissector, was in group-D. After receiving written informed consent from the patients they were operated on as the first and second cases in each OT List. Blood loss was measured during the operative procedure and calculated by the number of blood-soaked gauzes and post-operative pain was measured by the VAS pain scale, the house officer, and resident doctors on the floor. Results: Females predominance was observed in this study, Female to a male ratio in Group C was 2:1, and in Group D it was 3:1 The Mean ± Standard Deviation of the ages were 11.75 ± 3.25 yrs. and 14.25 ± 3.70 yrs. in both groups. The mean blood loss during tonsillectomy was 16.70 ± 4.70 ml in Group C and 50.70 ± 30.50 in Group D, a statistically significant difference was observed between the two groups and the p-value was < 0.05. The mean time duration of tonsillectomy was 14.10 ± 2.5 minutes in Group C and 20.40 ± 3.50 in Group D. Practical implication: Nowadays monopolar electrocautery is used for tonsillectomy because in this method intraoperative bleeding is minimum and operative time is also short Conclusion: Intra-operative bleeding was minimum while tonsillectomy was done by monopolar cautery and postoperative pain was more in this method which was controlled by analgesics. Keywords: tonsillectomy, cold steel dissection, monopolar electrocautery, intraoperative blood loss, postoperative pain, PACU

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“…Tonsillectomy is one of the prevalent surgical procedures; more than 500,000 cases of tonsillectomy are performed on children annually in the United States. [ 1 ] Complications after this surgery may include pain, dehydration, and bleeding. Post- tonsillectomy hemorrhage (PTH) is one of the most serious complications.…”

Section: Introductionmentioning

confidence: 99%

“…However, this method increases the pain and discomfort during swallowing and also increases the possibility of inflammation, edema, and spasm of the larynx muscles. [ 1 4 ] The best time to start pain control is when the anesthetics have stopped and the patient is regaining consciousness. In general, pain control in the recovery room is the best time.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

Masoudifar,

Rezaeian,

Mosharaf

2023

Advanced Biomedical Research

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Background: Considering the high prevalence of tonsillectomy in children and concerns of postoperative management, this study was conducted with the aim of evaluating the effects of oxymetazoline on bleeding, cough, and sore throat in children undergoing tonsillectomy. Materials and Methods: The current double-blind clinical trial study was conducted on 88 tonsillectomy candidate patients. These patients were randomly divided into two groups. In the first group, oxymetazoline 0.05% nasal spray (OXY group) and in the second group, distilled water spray (Control group) was prescribed as one puff in each nostril immediately after anesthesia induction., the nasal spray was prescribed again in both nostrils at 12 h after tonsillectomy. Then the hemodynamic parameters, post-tonsillectomy hemorrhage (PTH) and sore throat were evaluated. Results: The mean of the sore throat of children was not significantly different between the two groups in any of the follow-up times ( P value >0.05). PTH in recovery and in the ward in the OXY group with the mean of 57.60 ± 71.82 ml and 22.11 ± 22.50 ml, respectively, was significantly lower than the control group (83.50 ± 113.64 ml and 27.52 ± 35.11 ml) ( P value < 0.05). Also, the frequency of cough in the ward in the OXY group with 27.3% was significantly lower than the control group with 56.8% ( P value = 0.005). Conclusion: Regarding the results of the present study, sore throat and hemodynamic parameters did not change significantly with the administration of oxymetazoline. But this drug has played a significant role in reducing PTH and cough in children.

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Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

Cited by 4 publications

References 10 publications

Haemorrhage Rates After Two Commonly Used Tonsillectomy Methods: a Multicenter Study

Haemorrhage Rates After Two Commonly Used Tonsillectomy Methods: a Multicenter Study

Comparison of Complications after Tonsillectomy between Conventional Cold Steel Dissections Method and Electrocautery Tonsillectomy Method. A Randomized Controlled Trial

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

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