Post-operative morbidity following paediatric tonsillectomy; a comparison of bipolar diathermy dissection and blunt dissection

MacGregor, Fiona B.; Albert, David; Bhattacharyya, Amiya Kumar

doi:10.1016/0165-5876(94)01057-5

Cited by 41 publications

(41 citation statements)

References 13 publications

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“…In the present study, post-tonsillectomy hemorrhage requiring return to operating room occurred in 1.1% of the patients and eight patients (0.8%) required cauterization to control bleeding. The rate of total hemorrhage requiring after bipolar tonsillectomy has been reported to be between 1.7 and 12% (Table 1) [19][20][21][22][23][24][25][26][27][28][29][30][31]. Primary hemorrhage was documented in 0.4 and 1.4% of the patients in two studies [20,31].…”

Section: Discussionmentioning

confidence: 96%

“…Postoperative hemorrhage following bipolar cautery tonsillectomy ranged from 1.7 to 12.1% [18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Bipolar cautery tonsillectomy is not always used in conjunction with the microscope; however, the use of microscope may allow detection of the exposed vessels that are not actively bleeding, in the tonsillar fossa.…”

Section: Introductionmentioning

confidence: 99%

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Rate of post-tonsillectomy hemorrhage after elective bipolar microcauterization of nonbleeding vessels

Ulualp

2011

Eur Arch Otorhinolaryngol

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The objective of this paper is to describe an extended microscopic hemostasis technique involving cauterization of exposed blood vessels that were not actively bleeding in tonsillar fossa after bipolar tonsillectomy and to assess the rate of post-tonsillectomy hemorrhage with this technique in children who had bipolar tonsillectomy. The medical records of children who underwent microscopic bipolar tonsillectomy with extended hemostasis between June 2008 and January 2011 were reviewed. Relevant history and physical examination, diagnosis, and characteristics of postoperative hemorrhage were recorded; 994 children (531 males, 463 females), aged between 1 and 18 years (6 ± 3 years), underwent tonsillectomy; of the 994 patients, 11 (1.1%) developed post-tonsillectomy hemorrhage. No primary post-tonsillectomy hemorrhage occurred. The hemorrhage was seen 6-13 days after the surgery. One patient had bleeding after having trauma to the neck on postoperative day 13. Of the 11 patients with post-tonsillectomy bleeding, 3 had blood clot with no active bleeding and 8 exhibited active bleeding after removal of blood clot. Of the 994 patients, 8 (0.8%) needed intervention to control active bleeding. Compared to previous studies of bipolar tonsillectomy, extended microscopic hemostasis achieved by cauterization of tonsil fossa non-bleeding blood vessels appeared to reduce bleeding rate after bipolar cautery tonsillectomy. The present study did not include a control arm; further randomized controlled studies are needed to establish the definite effect of extended microscopic hemostasis technique on the rate of hemorrhage rates after tonsillectomy techniques.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Rate of post-tonsillectomy hemorrhage after elective bipolar microcauterization of nonbleeding vessels

Ulualp

2011

Eur Arch Otorhinolaryngol

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“…There is no consensus on the optimum method of performing tonsillectomy. Various methods have been described which are frequently compared and discussed in otolaryngology literature 14 . Advocates of cold blunt dissection tonsillectomy have presented evidence that the healing is more rapid and post operative pain less than other techniques 10 -15 .…”

Section: Discussionmentioning

confidence: 99%

Diode laser versus blunt dissection tonsillectomy

Matin

Chowdhury²

2012

Bangladesh J of Otorhinolaryngology

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“…In addition, the technique used for adenoidectomy influences postoperative pain and time taken to resume a normal diet, and it is therefore important for a rapid recovery [15][16][17]. This aspect is now particularly topical in Italy as the interest in day case surgery is growing and quick, and safe techniques with a short recovery time are favoured.…”

Section: Introductionmentioning

confidence: 99%