[Novel tonsillectomy technique].
BACKGROUND
Coblation (Co) is a relatively new technique, which may offer a better postoperative course after tonsillectomy than traditional techniques. The purpose of this study was to determine whether Co outperforms classic dissection. Coblation uses radiofrequency energy to excite the electrolytes in a saline solution, creating a precisely focused plasma. The plasma's energized particles have sufficient energy to break molecular bonds within tissue, causing the tissue to dissolve at temperatures between 40 degrees C and 70 degrees C.


METHODS
A case-control study was conducted in which 26 patients undergoing Co tonsillectomy were matched concerning gender, age and the surgeon's charge with 26 patients undergoing classic tonsillectomy. Furthermore, to compare the rates of postoperative haemorrhage, we reviewed the health records of all patients undergoing Co (60 patients) and routine dissection tonsillectomy (403) at Roskilde County Hospital.


RESULTS
Intraoperative bleeding was significantly lower in the Co group (median (MD) 5.0 ml; range (R) 1-32 ml) than in the control group (MD 10.0 ml; R 5-200 ml) (p < 0.0001). The median operation time was also significantly shorter for the Co group (23 min.; R 13-40 min. vs. 32 min.; R 21-63 min.; p = 0.002). Postoperatively, there was no significant difference between the two groups regarding pain scores, analgesics intake, time to return to work and normal diet or weight changes. Neither the primary (0% vs. 2%, p = 0.60) nor the secondary (3.3% vs. 2.5%, p = 0,66) haemorrhage rate was significantly different between Co and traditional tonsillectomy.


CONCLUSIONS
The intraoperative bleeding was lower and the surgery times were shorter in the Co group compared with classic dissection. There was no difference in the postoperative haemorrhage rate between the two tonsillectomy methods.
Toft
Jan Green
JG
Øre-naese-hals-kirurgisk Afdeling, Køge Sygehus, DK-4600 Køge.
Guldfred
Liviu-Adelin
LA
Holmgaard Larsen
Bent Ivan
BI
Becker
Birgit Claudia
BC
D000328:Adult; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000295:instrumentation; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D019106:Postoperative Hemorrhage / Q000209:etiology; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery