Ligasure versus cold knife tonsillectomy.
OBJECTIVE
To assess parameters related to ligasure tonsillectomy (LT) versus cold knife tonsillectomy (CKT) procedure.


METHODS
Prospective randomized study.


METHODS
A prospective study was conducted on 200 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy, or any procedure together with tonsillectomy, and patients with peritonsillar abscess history or bleeding disorders were excluded. Patients were randomly assigned to either the LT or CKT group. Intraoperative bleeding, operative time, postoperative pain using a visual analogue scale, and complication rates were evaluated.


RESULTS
The LT and CDT groups consisted of 108 and 92 individuals, respectively. In the LT group, there was no measurable intraoperative bleeding, whereas mean bleeding for CKT group was 125 mL. The mean operative time was 15 +/- 1.43 minutes for the LT group and 21 +/- 1.09 minutes for the CKT group (P < .001). The overall mean pain score for the LT group was 3.63, whereas for the CKT group it was 5.09 (P < .001). Primary hemorrhage occurred in one subject of the CKT group. Secondary postoperative hemorrhage was noticed two subjects of the LT group and two subjects of the CKT group. In 21 subjects of the LT group, limited peritonsillar edema was noticed. No other complication occurred in both groups.


CONCLUSIONS
LT procedure provides sufficient hemostasis, lower postoperative pain, and reduced operative time, as well as safety against Creutzfeld Jakob disease transmission.
Lachanas
Vassilios A
VA
Department of Otorhinolarygology-Head and Neck Surgery, University of Crete School of Medicine, 3 Myrtias Street, 71409 Heraklion, Crete, Greece.
Prokopakis
Emmanuel P
EP
Bourolias
Constantinos A
CA
Karatzanis
Alexander D
AD
Malandrakis
Stylianos G
SG
Helidonis
Emmanuel S
ES
Velegrakis
George A
GA
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain; D011183:Postoperative Complications; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D014068:Tonsillectomy / Q000295:instrumentation / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery; D016896:Treatment Outcome