Abstract
Background: Tonsillectomy is a common surgical
procedure in pediatric patients with high intensity of postoperative pain. The
aim of this study was to compare the duration of surgery and postoperative pain
and complications in pediatric patients who underwent tonsillectomy with
coblation and bipolar technique.
Methods: This retrospective study included 78 patients who
underwent total tonsillectomy between May 2018 and April 2019 using coblation
(n = 37) and bipolar (n = 41) dissection techniques aged 5-13 years. Operative
time, postoperative pain scores and complications were compared between the
groups
Results: Mean operative time was significantly longer in
coblation tonsillectomy group than bipolar tonsillectomy group (p <0.001).
Mean pain scores after coblation tonsillectomy was significantly less on
postoperative first (p <0.001), second (p = 0.019) and third (p = 0.041)
days compared to mean pain scores of patients undergoing bipolar tonsillectomy.
Postoperative bleeding was less frequent in the coblation tonsillectomy group
than in the bipolar tonsillectomy group (p = 0.034).
Conclusions: Coblation tonsillectomy in children
is an extremely safe technique associated with less postoperative pain and
morbidity, despite longer operating times and more cost than bipolar
tonsillectomy.
References
- 1) Polites N, Joniau S, Wabnitz D, Fassina R, Smythe C, Varley P et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial. Aust N Z J Surg 2006;76:226–9.
- 2) Çakır A, Boran C, Olgun Y, Erdağ TK. Tonsillektomi sonrası kanama: 10 yıllık deneyimimiz. Kulak Burun Bogaz Ihtis Derg 2017;27(1):1-9.
- 3) Tuchtan L, Torrents J, Lebreton-Chakour C, Niort F, Christia-Lotter MA, Delmarre E, et al. Liability under post-tonsillectomy lethal bleeding of the tonsillar artery: a report of two cases. Int J Pediatr Otorhinolaryngol 2015;79:83-7.
- 4) Wiltshire D, Cronin M, Lintern N, Fraser-Kirk K, Anderson S, Barr R, et all. The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques. J Laryngol Otol. 2018;132(3):240-5.
- 5) Elbadawey MR, Hegazy HM, Eltahan AE, Powell J. A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy. J Laryngol Otol. 2015;129(11):1058-63.
- 6) Temple R, Timms M. Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;61:195–8
- 7) Stoker K, Don D, Kang R, Haupert M, Magit A, Madgy D. Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled, single-blind study. Otolaryngol Head Neck Surg 2004;130:666–75
- 8) Lane JC, Dworkin-Valenti J, Chiodo L, Haupert M. Postoperative tonsillectomy bleeding complications in children: A comparison of three surgical techniques. Int J Pediatr Otorhinolaryngol. 2016;88:184-8.
- 9) Stalder KR, Woloszko J, Brown IG, Smith CD. Repetitive plasma discharges in saline solutions. Appl Phys Lett 2001;79:4503–5
- 10) Woloszko J, Stalder KR, Brown IG. Plasma characteristics of repetitivelypulsed electrical discharges in saline solutions used for surgical procedures. IEEE Trans Plasma Sci IEEE Nucl Plasma Sci Soc 2002;30:1376–83
- 11) Østvoll E, Sunnergren O, Ericsson E, Hemlin C, Hultcrantz E, Odhagen E, et al. Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden. Eur Arch Otorhinolaryngol 2015;272:737-43.
- 12) Windfuhr JP, Verspohl BC, Chen YS, Dahm JD, Werner JA. Post-tonsillectomy hemorrhage-some facts will never change. Eur Arch Otorhinolaryngol 2015;272:1211-8.
- 13) Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley L, Browne J, et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717-24
Abstract
Amaç: Tonsillektomi
ameliyat sonrası ağrı şiddeti fazla olan ve çocuk hastalarda sık uygulanan
cerrahi bir işlemdir. Bu çalışmada koblasyon ve bipolar teknikle tonsillektomi
yapılan çocuk hastalarda ameliyat süresinin ve ameliyat sonrası ağrı ve gelişen
komplikasyonların karşılaştırılması amaçlandı.
Materyal ve
Metod: Bu retrospektif çalışmaya yaşları 5-13 arasında değişen koblasyon
(n=37) ve bipolar (n=41) diseksiyon teknikleri kullanılarak Mayıs 2018 ve Nisan
2019 tarihleri arasında total tonsillektomi yapılan toplam 78 hasta dahil
edildi. Gruplar arasında ameliyat süresi, ameliyat sonrası ağrı şiddeti ve
komplikasyonlar karşılaştırıldı.
Bulgular:
Ortalama ameliyat süresi koblasyonton sillektomi yapılan grupta bipolar tonsillektomi
yapılan gruba göre anlamlı derecede uzundu (p<0.001). Koblasyon tonsillektomi
sonrası ağrı ameliyat sonrası birinci (p<0.001), ikinci (p=0.019) ve üçüncü
(p=0.041) günlerde bipolar tonsillektomi sonrası ağrı ile kıyaslandığında
anlamlı derecede daha azdı. Ameliyat sonrası kanama bipolar tonsillektomi
grubuna kıyasla koblasyon tonsillektomi grubunda daha az sıklıkta gözlendi
(p=0.034).
Sonuç:
Çocuklarda koblasyon tonsillektomi bipolar tonsillektomiye kıyasla daha uzun
ameliyat sürelerine ve daha fazla maliyete rağmen ameliyat sonrası daha az ağrı
ve morbiditeyle ilişkili son derece güvenli bir tekniktir.
Keywords
References
- 1) Polites N, Joniau S, Wabnitz D, Fassina R, Smythe C, Varley P et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial. Aust N Z J Surg 2006;76:226–9.
- 2) Çakır A, Boran C, Olgun Y, Erdağ TK. Tonsillektomi sonrası kanama: 10 yıllık deneyimimiz. Kulak Burun Bogaz Ihtis Derg 2017;27(1):1-9.
- 3) Tuchtan L, Torrents J, Lebreton-Chakour C, Niort F, Christia-Lotter MA, Delmarre E, et al. Liability under post-tonsillectomy lethal bleeding of the tonsillar artery: a report of two cases. Int J Pediatr Otorhinolaryngol 2015;79:83-7.
- 4) Wiltshire D, Cronin M, Lintern N, Fraser-Kirk K, Anderson S, Barr R, et all. The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques. J Laryngol Otol. 2018;132(3):240-5.
- 5) Elbadawey MR, Hegazy HM, Eltahan AE, Powell J. A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy. J Laryngol Otol. 2015;129(11):1058-63.
- 6) Temple R, Timms M. Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;61:195–8
- 7) Stoker K, Don D, Kang R, Haupert M, Magit A, Madgy D. Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled, single-blind study. Otolaryngol Head Neck Surg 2004;130:666–75
- 8) Lane JC, Dworkin-Valenti J, Chiodo L, Haupert M. Postoperative tonsillectomy bleeding complications in children: A comparison of three surgical techniques. Int J Pediatr Otorhinolaryngol. 2016;88:184-8.
- 9) Stalder KR, Woloszko J, Brown IG, Smith CD. Repetitive plasma discharges in saline solutions. Appl Phys Lett 2001;79:4503–5
- 10) Woloszko J, Stalder KR, Brown IG. Plasma characteristics of repetitivelypulsed electrical discharges in saline solutions used for surgical procedures. IEEE Trans Plasma Sci IEEE Nucl Plasma Sci Soc 2002;30:1376–83
- 11) Østvoll E, Sunnergren O, Ericsson E, Hemlin C, Hultcrantz E, Odhagen E, et al. Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden. Eur Arch Otorhinolaryngol 2015;272:737-43.
- 12) Windfuhr JP, Verspohl BC, Chen YS, Dahm JD, Werner JA. Post-tonsillectomy hemorrhage-some facts will never change. Eur Arch Otorhinolaryngol 2015;272:1211-8.
- 13) Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley L, Browne J, et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717-24
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 25, 2019 |
| Submission Date | July 5, 2019 |
| Acceptance Date | October 25, 2019 |
| Published in Issue | Year 2019 Volume: 16 Issue: 3 |
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty