Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage

Belloso, Antonio; Chidambaram, Ambika G.; Morar, Pradeep; Timms, M. S.

doi:10.1097/00005537-200311000-00029

Cited by 131 publications

(94 citation statements)

References 20 publications

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“…In our study, we found that nearly 86 % of patients were already on oral antibiotics at the time of presentation with secondary haemorrhage. Belloso et al [12] in their study report secondary haemorrhage rate of 2.25 % for coblation tonsillectomy compared to 6.19 % for cold dissection.…”

Section: Discussionmentioning

confidence: 90%

High Incidence of Post-Tonsillectomy Secondary Haemorrhage Following Coblation Tonsillectomy

Praveen

Parthiban

Terry

2012

Indian J Otolaryngol Head Neck Surg

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To examine the incidence of haemorrhage following tonsillectomy, to explore the usefulness of antibiotic in preventing postoperative haemorrhage and to examine if the haemorrhage depended on the level of expertise of the surgeon. A retrospective review analysing tonsillectomy method, the rate secondary haemorrhage, the grade of operating surgeon. A v 2 analysis was used to determine the statistical difference between the haemorrhage rates of different tonsillectomy methods. One thousand three hundred and thirty-six tonsillectomies were performed during this period by four different methods: 615 by cold steel dissection, 582 by Coblation, 32 by bipolar dissection and 107 by Helica thermal coagulation. 621 tonsillectomies were performed by Consultant grade and middle grades performed 693 operations. 124 patients (9.3 %) were readmitted with haemorrhage. The secondary haemorrhage requiring surgery for controlling bleeding for cold steel dissection method was 1.5 % compared to 6.7 % for coblation method (P \ 0.01 %), 6.3 % for bipolar dissection and 1.9 % for Helica thermal coagulation method. Overall consultants had a post tonsillectomy haemorrhage rate of 5.5 % and middle grades had a rate of 3.7 %. 86.5 % of the patients were already on routine prophylactic oral antibiotics at the time of presentation with haemorrhage needing surgical arrest and 13.5 % were not on antibiotics (P \ 0.05 %). There was statistically significant difference in secondary haemorrhage rate between coblation and cold steel dissection methods. Coblation tonsillectomies had an increased need for operative intervention to control secondary haemorrhage. Routine use of antibiotic and expertise of operating surgeon had no bearing on secondary haemorrhage rate.

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Section: Discussionmentioning

confidence: 90%

High Incidence of Post-Tonsillectomy Secondary Haemorrhage Following Coblation Tonsillectomy

Praveen

Parthiban

Terry

2012

Indian J Otolaryngol Head Neck Surg

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“…4 In their study they found that coblation tonsillectomy was associated with a lesser incidence of delayed hemorrhage, significantly in the pediatric population. They found that secondary re-bleed rate with coblation was 2.25% versus 6.19% in the control group.…”

Section: Discussionmentioning

confidence: 95%

“…These findings were in consonance with earlier studies by Belloso and Magdy. 4,7 Most of the studies involving coblation tonsillectomies have focused on adults and adolescents whose clinical data were not applicable for children. The present study sought to find the clinical advantages of coblation if any by assessing clinical outcomes of coblation tonsillectomy compared to cold dissection tonsillectomy especially in children…”

Section: Discussionmentioning

confidence: 99%

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Nithya

Dutta

Sabarigirish

2016

Int J Otorhinolaryngol Head Neck Surg

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Background: The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.Methods: A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups. Results: Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value <0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant. Conclusions: This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period.

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“…(2) Tonsillectomy has been practiced for more than 2000 years (Celsus, 30 B.C.). (1,3) Although indications for tonsillectomy have included a large number of conditions over the years, most procedures have traditionally been performed to address infection, either recurrent or chronic. More recently, a trend towards airway obstruction as a common indication for tonsillectomy has emerged because of increasing information about the causes and sequelae of obstructive sleep apnea (OSA).…”

Section: Introductionmentioning

confidence: 99%

Coblation tonsilloadenoidectomy - treatment of choice for very small children

Roje

Škrabić

Stipić

2014

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Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage

Cited by 131 publications

References 20 publications

High Incidence of Post-Tonsillectomy Secondary Haemorrhage Following Coblation Tonsillectomy

High Incidence of Post-Tonsillectomy Secondary Haemorrhage Following Coblation Tonsillectomy

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Coblation tonsilloadenoidectomy - treatment of choice for very small children

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