Thulium laser versus cold steel tonsillectomy: a prospective pilot study in adult patients

Abstract

Background The aim of this pilot study was to compare the operation time, intraoperative and postoperative bleeding, postoperative pain, and wound healing of the thulium RevoLix laser tonsillectomy method over the more commonly practiced cold steel tonsillectomy. Methods A prospective, single-blinded randomized pilot trial was conducted. Twenty-four adult patients with a mean age of 28.7 years with chronic recurrent tonsillitis were observed and underwent tonsillectomy. The patients were randomly assigned to have one tonsil removed with a thulium RevoLix laser 200, and the conventional cold steel tonsillectomy method was used for the other side. Results The tonsillectomy time from incision to hemostasis was 12.08 ± 0.77 (SE) min with the laser method and 10.92 ± 1.31(SE) min with the cold dissection method, with no statistically significant difference (P < 0.121). Intraoperative blood loss in the cold dissection method was 10.92 ± 1.31 ml, and 2.04 ± 1.62 ml was observed during laser treatment (P < 0.000, t = 8.363). In the cold steel tonsillectomy group, the pain score was significantly higher than that in the laser tonsillectomy group on the 7th and 12th postoperative days. Conclusion The use of the thulium RevoLix 200 laser for tonsillectomy in the present pilot study of 24 patients showed significantly better outcomes than those in conventional cold dissection methods in terms of intraoperative bleeding and postoperative pain; however, there was no statistically significant difference in other parameters, such as operational time and late postoperative bleeding. A large full-scale prospective study is needed to increase the generalizability and reliability of the results. Clinical trial registration ISRCTN16280803, registered on 25 March 2020, https://www.isrctn.com/ISRCTN16280803.