Journals / KBB-Forum / 2011 / Cilt: 10 - Sayı: 4

Comparison between traditional cold dissection and bipolar electrodissection tonsillectomy on the same patient

Aynı hastada konvansiyonel soğuk diseksiyon tekniği ile bipolar elektrokoter tonsillektominin karşılaştırılması

Journal
KBB-Forum
Pages
46–49
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, the number of observed post operative hemorrhage for both BET and TCT was close to one another; therefore mentioned techniques, in terms of hemorrhage, did not significantly differ from one another.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: The purpose of this study is to make clearer and more objective comparisons between Bipolar Electrodissection Tonsillectomy (BET) and Traditional Cold Dissection Tonsillectomy (TCT) by comparing the results of both tecniques performed on the same patient.
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Key Findings & Data:Patients and Methods: One hundred and four patients with a ratio of 54 females and 50 males aged from 6 to 32 (with a mean of 10.2 ± 4.2 years) with either a tonsillectomy or an adenotonsillectomy have participated to the study.
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Conclusion & Impact:However, the number of observed post operative hemorrhage for both BET and TCT was close to one another; therefore mentioned techniques, in terms of hemorrhage, did not significantly differ from one another.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Purpose: The purpose of this study is to make clearer and more objective comparisons between Bipolar Electrodissection Tonsillectomy (BET) and Traditional Cold Dissection Tonsillectomy (TCT) by comparing the results of both tecniques performed on the same patient. Patients and Methods: One hundred and four patients with a ratio of 54 females and 50 males aged from 6 to 32 (with a mean of 10.2 ± 4.2 years) with either a tonsillectomy or an adenotonsillectomy have participated to the study. TCT was applied to the right-side of each of the participants, while BET was performed to the left-side. The results were compared in terms of time spent in operations, postoperative pain and postoperative bleeding. Resuts: The avarage time spent on the left-side tonsillectomy was found as 5.6 ± 1.3 minutes ranging from 4-10 minutes; on the other hand the average of the time spent on the right-side tonsillectomy was 4.9 ± 1.3 minutes ranging from 3-9 minutes (p<0.05). Observed postoperative bleeding for right-side was 2 (1.9%); meanwhile 3 (2.9%) postoperative bleeding was seen on the left-sided tonsillectomies. By the end of postoperative 2nd hour, 17 (16.3%) patients had complained that they had more pain on the right side; however, 36 (34.6%) of them felt more pain on the left-side. Further, remaining 51 (49%) patients reported the same amount of pain on both-sides. The following day, the number of patients experiencing relatively more pain on the left-side has droped down to 14(13.5%); on the contrary, the number of patients having relatively more pain on the right-side has increased up to 26(25%). Conclusion: Both operation techniques were compared with regards to time spent on operations, postoperative bleeding and pain. First of all, with respect to the operations examined in this study, average surgery time on BET is found significantly longer than the avarage time spent on TCT. Secondly, considering the postoperative pain, BET is more painful than CTC for shorter-terms; however as time passes, such as the next day, experienced postoperative pain for BET is significantly less than the pain for CTC (p<0.05). However, the number of observed post operative hemorrhage for both BET and TCT was close to one another; therefore mentioned techniques, in terms of hemorrhage, did not significantly differ from one another.

Özet

Amaç: Bu çalışmanın amacı, daha objektif karşılaştırma yapabilmek amacıyla aynı olgu üzerinde, sağ tarafına klasik soğuk diseksiyon tonsillektomi ve sol tarafına bipolar tonsillektomi yapılan hastaların sonuçlarının değerlendirilmesi. Hastalar ve metod: Yaşları 6 ile 32 arasında olan(ortalama 10.2±4.2), tonsillektomi veya adenotonsillektomi planlanan 54'ü kadın(%51.9) 50'si erkek(%48.1) olmak üzere toplam 104 hasta çalışmaya dahil edildi. Hastaların sağ tonsillerine klasik soğuk diseksiyon yöntemi, sol tonsillerine ise bipolar elektrokoter yöntemiyle tonsillektomi yapıldı. Cerrahi süreleri, postoperatif ağrı ve kanama yönünden sonuçları karşılaştırıldı. Sonuçlar: Sol tonsillektomi için ortalama cerrahi süresi 5.6±1.3 dakika (min.4 – maks.10), sağ tonsillektomi için ortalama cerrahi süresi 4.9±1.3 dakika (min.3 - maks.9) olarak bulundu(p<0.05). Hastaların 2(%1.9) tanesinde sağ tarafta, 3(%2.9) tanesinde ise sol tarafta postoperatif kanama meydana geldi. Postoperatif 2. saatte 17(%16.3) hasta ağrısının sağda daha çok olduğunu, 36(%34.6) hasta ağrısının solda daha çok olduğunu ve 51(%49) hasta ise ağrısının heriki tarafta da aynı şiddette olduğunu söylemiştir. Ameliyatın 24. saatinde ise hastaların 26'sında(%25) sağ tarafında, 14'ünde(%13.5) sol tarafında göreceli olarak ağrının daha çok olduğu tespit edilmiştir. Tartışma: Her iki cerrahi teknik süre, postoperatif kanama ve ağrı yönünden karşılaştırıldı. Bipolar tonsillektominin uygulanma süresi klasik diseksiyona göre anlamlı olarak uzun bulundu. Postoperatif ağrı bipolar tonsillektomide ilk gün daha fazla ancak sonraki günlerde anlamlı olarak daha az bulundu(p<0.05). Bununla birlikte postoperatif kanama oranı her iki teknikte de birbirine yakın bulundu.

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Cite This Article

AKBAY, E., ÇOKKESER, Y., KAHRAMAN, Ş. Ş. (2011). Comparison between traditional cold dissection and bipolar electrodissection tonsillectomy on the same patient. KBB-Forum, Cilt: 10 - Sayı: 4, 46–49. https://ajindex.com/articles/199403

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References (14)

  1. Karatzias GT, Lachanas VA, Sandris VG. Thermal welding versus bipolar tonsillectomy: a comparative study. Otolaryngol Head Neck Surg. 2006;134(6):975-8
  2. Yorgancılar E, Yıldırım M, Gün R, Meriç F. Soğuk disseksiyon tekniğine karşı plazmakinetik tonsillektomi tekniğinde postoperatif ağrının karşılaştırılması. KBBForum. 2010;9(1):5-8
  3. Krishna P, LaPage MJ, Hughes LF, Lin SY. Current practice patterns in tonsillectomy and perioperative care. Int J Pediatr Otorhinolaryngol. 2004;68(6):779-84
  4. Belloso A, Chidambaram A, Morar P, Timms MS. Coblation tonsillectomy versus dissection tonsillectomy: postoperative hemorrhage. Laryngoscope. 2003;113(11):2010-3
  5. Hasan H, Raitiola H, Chrapek W, Pukander J. Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy. Eur Arch Otorhinolaryngol. 2008;265(7):817-20
  6. Sharma K, Kumar D. Ligation versus bipolar diathermy for hemostasis in tonsillectomy: A comparative study. Indian J Otolaryngol Head Neck Surg 2011;63(1):15–19
  7. Lassaletta L, Martín G, Villafruela MA, Bolaños C, Alvarez- Vicent JJ. Pediatric tonsillectomy: post-operative morbidity comparing microsurgical bipolar dissection versus cold sharp dissection. Int J Pediatr Otorhinolaryngol. 1997;41(3):307- 17
  8. Silveira H, Soares JS, Lima HA. Tonsillectomy: cold dissection versus bipolar electrodissection. Int J Pediatr Otorhinolaryngol. 2003;67(4):345-51
  9. Özkiriş M. Çocuk tonsillektomilerinde bipolar koter diseksiyon ve klasik diseksiyon tekniklerinin karşılaştırılması. J Kartal TR. 2010;21(1):22-7
  10. Somdas MA, Senturk M, Ketenci I, Erkorkmaz U, Unlu Y. Efficacy of bupivacaine for post-tonsillectomy pain: a study with the intra-individual design. Int J Pediatr Otorhinolaryngol. 2004;68(11):1391-5
  11. Parsons SP, Cordes SR, Comer B. Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol Head Neck Surg. 2006;134(1):106-13
  12. Shapiro NL, Bhattacharyya N. Cold dissection versus coblation-assisted adenotonsillectomy in children. Laryngoscope. 2007;117(3):406-10
  13. Isaacson G, Szeremeta W. Pediatric tonsillectomy with bipolar electrosurgical scissors. Am J Otolaryngol. 1998;19(5):291-5
  14. Iqbal Z, Rabbani MZ, Zafar MJ. Post tonsillectomy hemorrhage incidence: a comparison between dissection and bipolar diathermy techniques. Rawal Medical Journal. 2009;34(1):23-5.