Tonsillectomy: cold dissection versus bipolar electrodissection.
OBJECTIVE
to compare the technique and post-operative morbidity of two different tonsillectomy methods: cold dissection and bipolar electrodissection.


METHODS
prospective study including children (3> age <14) undergoing tonsillectomy in ORL Department of the main hospital in Azores, Portugal, from September 2000 to March 2001. Patients alternately selected to cold dissection tonsillectomy group (CDT) or bipolar electrodissection tonsillectomy group (BET). Duration of surgery; amount of blood loss; duration of hospitalization; aspect of tonsillar fossa on 10th post-operative day and intensity of pain after surgery were recorded and compared.


RESULTS
Sixty tonsillectomies were performed. Blood loss and duration of surgery were significantly decreased in BET group (P<0.001), but the healing process, directly assessed by the aspect of tonsillar fossa on the 10th day was markedly delayed. The intensity of pain was slightly higher in the BET group compared with the CDT group, and no difference on duration of hospitalization was found between the two groups. Two post-operative hemorrhages occurred (one in each group), and no major complications were registered.


CONCLUSIONS
BET reduces the duration of surgery and amount of blood loss when compared with cold dissection, but post-operative morbidity is increased. We believe the best patient indication for this method are small children where total circulating blood volume is reduced and patients with bleeding disorders.
Silveira
Helena
H
Department of Otorhinolaryngology, Hospital Divino Espírito Santo, Ponta Delgada, S. Miguel, Azores, Portugal. hsilveira@aeiou.pt
Soares
José Silveira
JS
Lima
Hermano Almeida
HA
D000293:Adolescent; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000473:pathology / Q000601:surgery*