A Comparison between Cold Steel Method and Bipolar Diathermy Method of Tonsillectomy
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Abstract
Introduction
It is generally accepted that the ideal method of tonsillectomy should have less operative time, blood loss, post-operative haemorrhage and morbidity.1
Objective: To compare post-operative pain, intra-operative blood loss and duration of surgery between cold dissection and bipolar diathermy dissection method of Tonsillectomy.
Materials and Methods
This study was a prospective and comparative hospital-based study. It was conducted from January 2021 - June 2022 at the Department of ENT of a tertiary referral hospital, Kolkata. 90 patients were included in this study fulfilling the inclusion and exclusion criteria.
Results
In bipolar diathermy method, the mean total blood loss (in ml) (mean±s.d.) of patients was 15.0778±4.6011 and in cold steel method it was 33.0000±5.8737. Post-operative pain for cold dissection on day 1, day 3 and day 10 was [4.4889±.6613], [2.0222±.7830] and [.3778±.4903] respectively. Post-operative pain for bipolar diathermy on day 1, day 3 and day 10 was [4.9556±.2084], [2.5778±1.0111] and [1.6222±.7474] respectively. Duration (in minutes) for bipolar diathermy dissection was [15.2889±1.9612] and for cold dissection it was [24.0444±2.3351].
Conclusion
The blood loss and duration were less in bipolar diathermy method but post-operative pain was more as compared to cold steel method.
Keywords
Tonsillectomy, cold steel, bipolar diathermy, post-operative pain.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Gendy S, O'Leary M, Colreavy M, Rowley H, O'Dwyer T, Blayney A. Tonsillectomy--cold dissection vs. hot dissection: a prospective study. Ir Med J. 2005;98(10):243-4
Sharma K, Kumar D. Ligation versus bipolar diathermy for hemostasis in tonsillectomy: a comparative study. Indian J Otolaryngol Head Neck Surg. 2011;63(1):15-9
McNeill RA. A History of Tonsillectomy: Two Millenia of Trauma, haemorrhage and controversy. Ulster Med J. 1960;29(1):59-63
Roy A, Rosa C, Vecchio YA. Bleeding following tonsillectomy. A study of electrocoagulation and ligation techniques. Archives of Otolaryngology 1976; 102:9-10
Haase F, Noguera J. Haemostasis in tonsillectomy by electrocautery. Archives of Otolaryngology 1962; 75:125‐6. [PubMed] [Google Scholar]
Andreoli S, Josephson GD. Tonsillectomy and Adenoidectomy: Current Techniques and Outcomes. Int J Head Neck Surg. 2016;7(2):104-8
Andrea M. Microsurgical bipolar cautery tonsillectomy. Laryngoscope 1993; 103:1177‐8. [PubMed] [Google Scholar]
Carmody D, Vamadevan T, Cooper SM. Post tonsillectomy haemorrhage. The Journal of Laryngology & Otology [Internet]. 1982 Jul [cited 2021 Aug 23];96(7):635–8.
Phillips JJ, Thornton ARD. Tonsillectomy haemostasis: diathermy or ligation. Clinical Otolaryngology. 1989 Oct;14(5):419–24
Haase FR, Noguera JT. Hemostasis in Tonsillectomy by Electrocautery. Archives of Otolaryngology [Internet]. 1962 Feb 1 [cited 2021 Oct 10];75(2):125–6. Drake-Lee A, Stokes M. A prospective study of the length of stay of 150 children following tonsillectomy and/or adenoidectomy. Clinical Otolaryngology 1998; 23:491-5. [PubMed] [Google Scholar]
Drake‐Lee A, Stokes M. A prospective study of the length of stay of 150 children following tonsillectomy and/or adenoidectomy. Clinical Otolaryngology 1998; 23:491‐5. [PubMed] [Google Scholar]
Salam MA, Alam MM, Ahmed R, Mahmud MS. Monopolar Diathermy Tonsillectomy versus Dissection Method Tonsillectomy. KYAMC Journal. 2019 May 22;10(1):21-4
Muthubabu K, Rekha A, Thejas SR, Vinayak R, Srinivasan MK, Alagammai S, Thushita Nivasini S, Gayathri S. Tonsillectomy by cold dissection and coblation techniques: a prospective comparative study. Indian Journal of Otolaryngology and Head & Neck Surgery. 2019 Oct;71(1):665-70
Chettri ST, Bhandary S, Nepal A, Joshi RR, Natesh V, Sah SP, Sah BP, Koirala S. A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups. Health Renaissance. 2013;11(3):270-2
Chughtai A, Haq AU, Ullah S. Is the cold steel dissection method still the most effective method of tonsillectomy? PAFMJ. 2016 Oct 31;66(5):705-09.