Argon plasma coagulation versus cold dissection tonsillectomy in adults: a clinical prospective randomized study.
OBJECTIVE
Argon plasma coagulation (APC) is a new surgical procedure based on a conductive plasma of ionized argon between an activating electrode and a tissue surface. It is a good alternative for tonsillectomy because of its effective hemostasis and limited penetration depth of the coagulation beam. The aim of this prospective, randomized trial was to evaluate operative time, intraoperative bleeding, and postoperative morbidity of the "hot" APC tonsillectomy as with regard to with a traditional "cold" dissection tonsillectomy in adults.


METHODS
Two hundred twenty six adult patients (age, >18 years) were randomized into 2 groups: TA (tonsillectomy with APC, n = 113) and TB (conventional tonsillectomy, n = 113). The outcome measures were (1) operative time; (2) intraoperative blood loss; (3) postoperative pain (evaluated using a Visual Analogue Scale with a range score 0-10 on postoperative days 1, 3, 5, 8, and 15); and (4) postoperative primary and secondary hemorrhage. Statistical analysis was carried out using the Student t test.


RESULTS
In the TA group, the mean duration of operative time and the intraoperative blood loss were significantly reduced (P < .001). There was no statistically significant difference between 2 groups in the intensity of postoperative pain and the incidence of postoperative hemorrhage (P > .05).


CONCLUSIONS
Tonsillectomy with APC is a safe technique and offers an innovative procedure as with regard to the conventional cold dissection. It significantly reduces the operative time and the intraoperative blood loss without increasing the postoperative morbidity.
Ferri
Emanuele
E
Department of Otorhinolaryngology, Hospital of Dolo (Venice), Italy. emaferri@libero.it
Armato
Enrico
E
Capuzzo
Paolo
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010608:Pharyngeal Diseases / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome