[Comparison between bipolar cautery dissection and classic dissection techniques in tonsillectomy].
OBJECTIVE
We compared the results of tonsillectomy performed by classical dissection and bipolar cautery dissection in pediatric patients.


METHODS
A total of 201 pediatric patients were randomly assigned to two tonsillectomy groups. Ninety-five patients (62 boys, 33 girls; mean age 7+/-3 years) underwent bipolar cautery tonsillectomy, and 106 patients (58 boys, 48 girls; mean age 8+/-3 years) underwent classical dissection tonsillectomy. Patients were compared with respect to bleeding during tonsillectomy, operation time, tonsil volumes, primary and secondary bleeding, severity of pain at the first hour and on the tenth day, and time to first solid food intake.


RESULTS
With bipolar cautery tonsillectomy, the mean operation time, amount of perioperative bleeding, and pain score at the first hour were significantly lower (p<0.001). However, the mean pain score on the tenth day was significantly higher with cautery tonsillectomy, which significantly prolonged initiation of solid food intake (p<0.001). There were no significant differences between the two groups with respect to tonsil volumes and initiation of cold fluid nutrition at the third postoperative hour (p>0.05). In the late postoperative period, one patient in each group required intervention under general anesthesia to control bleeding.


CONCLUSIONS
Merits and demerits of both techniques should be taken into consideration for appropriate patient selection for the two tonsillectomy methods.
Berçin
Sami
S
Department of Otolaryngology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey. sbercin@hotmail.com
Kutluhan
Ahmet
A
Yurttaş
Veysel
V
Bozdemir
Kazim
K
Yalçiner
Gökhan
G
D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D002648:Child; D004210:Dissection / Q000592:standards*; D004435:Eating; D004564:Electrocoagulation / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods* / Q000592:standards