How we do it: Coblation tonsillectomy complication rates from a single ENT department compared with the National Prospective Tonsillectomy Audit

Clark, Matthew; Smithard, A.; Jervis, P.

doi:10.1111/j.1749-4486.2006.01172.x

Cited by 13 publications

(10 citation statements)

References 4 publications

(1 reference statement)

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“…In contrast, multiple other studies have concluded that the bleeding rate following Coblation tonsillectomy was not statistically different than with non‐Coblation procedures 31–34. The National Prospective Tonsillectomy Audit (NPTA) of Great Britain included 13,554 patients, of whom 60% were pediatric; in this review, 684 of the procedures were performed using the Coblation technique.…”

Section: Discussionmentioning

confidence: 92%

Coblation tonsillectomy in children: Incidence of bleeding

et al. 2012

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Section: Discussionmentioning

confidence: 92%

Coblation tonsillectomy in children: Incidence of bleeding

et al. 2012

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“…A number of articles have suggested an increased risk of haemorrhage in patients undergoing coblation tonsillectomy 6,11–13 . However, other investigators have not found this to be the case 14,15 . Belloso et al 16 showed a lower incidence of haemorrhage in the largest single study to date (2.25% in the coblation group versus 6.19% in the control group).…”

Section: Discussionmentioning

confidence: 99%

“…6,[11][12][13] However, other investigators have not found this to be the case. 14,15 Belloso et al 16 showed a lower incidence of haemorrhage in the largest single study to date (2.25% in the coblation group versus 6.19% in the control group). The present study was not intended to address this question.…”

Section: Secondary Haemorrhagesmentioning

confidence: 94%

A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis

Mitic

Tvinnereim²,

Lie

et al. 2007

Clinical Otolaryngology

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Objectives: To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis. Design: A prospective, single blind, randomised controlled trial. Setting: ENT clinic, University Teaching Hospital. Participants: Forty paediatric patients, aged between 4 and 12 years and between 16 and 60 kg in weight with standard indication for tonsillectomy. Methods: Patients were randomly allocated to either coblation tonsillectomy or dissection tonsillectomy groups. Patients, parents, and nurses were blinded for operation method. Parents were asked to fill out a postoperative diary from 1 to 10 days. Main outcome measures: Primary outcomes were scored for postoperative pain, nutrition, activity, and use of analgetics for each of the 10 postoperative days. Secondary outcomes were estimated from the nurses' postoperative data and 10-day follow-up statistics regarding crossing of the two-score limit.Results: The groups were statistically comparable by age, weight and operation type. There was no significant difference in operation time in two groups. Intra-operative bleeding was significantly less in the coblation group. Statistically significant differences between dissection tonsillectomy and coblation tonsillectomy were found in the day when a score of two of five was passed in pain scores (9.6 versus 6.2), nutrition scores (8.9 versus 6.6), activity score (8.4 versus 6.6) and medicine intake (9.4 versus 6.4), We found parallelism, between regression lines, that indicates better postoperative life quality for the coblation tonsillectomy group and approximately 2 days' shorter recovery time. Conclusion: In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.Tonsillectomy continues to be one of the most common procedures performed by ENT surgeons in Norway as well as worldwide. The most commonly used techniques in Norway include blunt dissection, guillotine, bipolar diathermy haemostasis, bipolar diathermy scissors and laser. Despite the use of multiple analgesics, postoperative pain and postoperative morbidity remain the major side effects of the operation.Coblation tonsillectomy has not been used routinely in public hospitals in Norway up to now. Coblation (cold ablation) is a relatively new technique in soft tissue surgery. Recently, the use of this new technique in the treatment of snoring, nasal congestion and sleep apnoea has received considerable research interest.Coblation is a bipolar system that involves passing radiofrequency through a medium of normal saline, which results in the production of a plasma field of sodium ions. These ions are able to break down interc...

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“…The ionised helium is used to dissect and coagulate the tissues [9]. Clark et al [11] report a secondary haemorrhage rate of 1.5 % for coblation with no patients returning to theatre for controlling haemorrhage. They report that patients were discharged on oral antibiotics after 24 h of intravenous antibiotics when they presented with bleeding.…”

Section: Discussionmentioning

confidence: 99%

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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How we do it: Coblation tonsillectomy complication rates from a single ENT department compared with the National Prospective Tonsillectomy Audit

Cited by 13 publications

References 4 publications

Coblation tonsillectomy in children: Incidence of bleeding

Coblation tonsillectomy in children: Incidence of bleeding

A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis

High Incidence of Post-Tonsillectomy Secondary Haemorrhage Following Coblation Tonsillectomy

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