Poor results of KTP Laser tonsillectomy compared with conventional dissection: a prospective clinical trial

Abstract

The aim of this study was to compare the clinical outcome of KTP Laser tonsillectomy with conventional dissection tonsillectomy. Seventy‐four Laser tonsillectomy patients (mean age 14 years, range 2–91 years) were compared prospectively with 157 conventional dissection tonsillectomy patients (mean age 18 years, range 2–71 years). KTP Laser tonsillectomy was performed using 0.6 fibre optic cable at 10 Watts continuous. Conventional dissection tonsillectomy was by standard techniques. Operating time, intra‐operative bleeding, postoperative pain at 1, 7 and 14 days, incidence of delayed healing, postoperative bleeding and hospital readmission were compared. There was no significant difference in operating time between Laser and conventional tonsillectomy. At days 1, 7 and 15 the Laser group reported significantly higher pain scores than the conventional group (P < 0.0001, Mann–Whitney U test) and showed evidence of delayed healing at 14 days (P < 0.0001, χ2 test). The Laser group had less intra‐operative bleeding (P < 0.02) but this effect disappeared when the confounding effect of age was controlled by analysing children under 12 separately. KTP Laser tonsillectomy results in significantly more postoperative pain and delayed healing compared with conventional dissection tonsillectomy. It is no quicker than conventional dissection tonsillectomy. Blood loss was less in the Laser group but this may be accounted for by younger age. KTP Laser should not replace conventional tonsillectomy as standard technique. It may have a limited role where minimizing intra‐operative blood loss is an overriding consideration.