Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection

Ragab, Sameh M.

doi:10.1017/s0022215112002022

Cited by 28 publications

(42 citation statements)

References 20 publications

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“…Traditional surgical techniques using the scalpel, guillotine, or snare have largely been replaced with techniques utilizing cautery to limit intraoperative blood loss. However, it has been reported that early post-operative pain may be more intense after the mechanical trauma of cold dissection technique, whereas hot methods may have a higher incidence of late post-operative pain [13]. In a systematic review of Leinbach et al [14] electrodissection caused increased postoperative pain in comparison with cold dissection tonsillectomy.…”

Section: Discussionmentioning

confidence: 98%

Postoperative Pain in Adult Tonsillectomy: Is There Any Difference Between the Technique?

Palacios

Álvarez-Morujo

Martínez

et al. 2017

Indian J Otolaryngol Head Neck Surg

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Tonsillectomy is one of the most common surgical procedures performed worldwide. Several techniques have been developed to reduce morbidity and enhance recovery after tonsillectomy. Our study was designed to compare post-operative pain with three different techniques: cold dissection (CD), monopolar-bipolar dissection (MBD) and coblation dissection (CBD). 103 adults were scheduled for elective tonsillectomy from September 2014 to December 2015, and were randomized to CD, MBD and CBD. Post-operative pain was assessed using visual analogue scale (VAS) and Lattinen Test (LT). We did not find significant differences between the groups in the VAS pain scores ( > 0.05), except for the first day, when CBD tonsillectomy showed a higher pain score ( < 0.05). The differences in LT scores between the three techniques were not statistically significant ( > 0.05). Comparison of analgesic consumption between CD, MBD and CBD did not found any significant differences irrespective of the technique used. When first and second week after surgery were compared, differences in analgesics requirements were statistically significant ( < 0.05). Seventeen cases (16.5%) of secondary haemorrhage were reported, but there were no statistical differences in the rate of postoperative bleeding between the three groups ( > 0.05). We conclude that in our study comparison of the three techniques, CD, MBD and CBD, did not show significant differences in the post-tonsillectomy pain scores and bleeding rate.

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Section: Discussionmentioning

confidence: 98%

Postoperative Pain in Adult Tonsillectomy: Is There Any Difference Between the Technique?

Palacios

Álvarez-Morujo

Martínez

et al. 2017

Indian J Otolaryngol Head Neck Surg

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“…Despite decreased operative time, a low rate of postoperative bleeding, and cost‐efficiency associated with these methods, the use of cold dissection has been abandoned at many institutions due to high intraoperative blood loss and perceived perioperative risk when compared to other methods . As a result, monopolar electrocautery gained popularity due to a reported decrease in intraoperative hemorrhage rate and ease of use . However, one study suggested increased postoperative pain secondary to the high continuous thermal energy (400°C to 600°C) used for dissection .…”

Section: Introductionmentioning

confidence: 99%

“…3 As a result, monopolar electrocautery gained popularity due to a reported decrease in intraoperative hemorrhage rate and ease of use. 4 However, one study suggested increased postoperative pain secondary to the high continuous thermal energy (400 C to 600 C) used for dissection. 4 Regarding the rate of postoperative hemorrhage, studies are largely contradictory without clear consensus.…”

Section: Introductionmentioning

confidence: 99%

“…4 However, one study suggested increased postoperative pain secondary to the high continuous thermal energy (400 C to 600 C) used for dissection. 4 Regarding the rate of postoperative hemorrhage, studies are largely contradictory without clear consensus. 5 Furthermore, some suggest monopolar cautery dissection increases operative time when compared to cold dissection.…”

Section: Introductionmentioning

confidence: 99%

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The utility of common surgical instruments for pediatric adenotonsillectomy

et al. 2014

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“…full slough = 0% healing ranging to no slough = 100% healing). 18,20 Other studies utilized the interpretation made by a single clinician's examination finding on designated post-operative days of follow-up (e.g. appointment at day 7 post tonsillectomy).…”

Section: Estimation Of Healed Areamentioning

confidence: 99%

Wound healing after tonsillectomy – a review of the literature

et al. 2018

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ObjectiveTo summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing.MethodsA search of the English literature was conducted using the Ovid Medline database, with the search terms ‘tonsillectomy’ or ‘tonsil’ and ‘wound healing’. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis.ResultsThe majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing.ConclusionWound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.

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Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection

Abstract: In this adult series, bipolar radiofrequency tonsillectomy was superior to ultrasonic, bipolar electrocautery and cold dissection tonsillectomies. This method combines the advantages of 'hot' and 'cold' tonsillectomy.

Cited by 28 publications

References 20 publications

Postoperative Pain in Adult Tonsillectomy: Is There Any Difference Between the Technique?

Postoperative Pain in Adult Tonsillectomy: Is There Any Difference Between the Technique?

The utility of common surgical instruments for pediatric adenotonsillectomy

Wound healing after tonsillectomy – a review of the literature

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