title: Tissue welding tonsillectomy provides an enhanced recovery compared to that after monopolar electrocautery technique in adults: a prospective randomized clinical trial.
abstract: We have compared tonsillectomy (TE) with tissue welding (TW) technology using a specially designed forceps versus conventional monopolar electrocautery to evaluate whether this new technology may improve recovery after TE. This was a single-blind, randomized clinical trial with two parallel groups. Sixty healthy adult day-surgery patients were allocated into the TW-TE group (n = 31) and the monopolar electrocautery-TE group (n = 29). We recorded intraoperative events and short- and long-term recovery for 2 weeks postoperatively. The patients and study nurses evaluating patients during recovery were blinded to the operation method used. All patients in the TW-TE group completed the study as per protocol, but in the monopolar electrocautery-TE group, there was one drop-out in the hospital and another after discharge. There was no difference in the perioperative parameters and early recovery between the two groups. After discharge, recovery was significantly faster in the TW group than in the monopolar group: (1) the duration of postoperative pain was 2 days shorter, and (2) activities of normal daily living were less affected, and (3) the need for hospital contacts after discharge, and (4) the incidence of postoperative bleeding was less in the TW group than that in the monopolar group. No patients in the TW group developed secondary bleeding versus three patients in the monopolar group requiring electrocautery to control bleeding. In conclusion; our results indicate that, TW technique may provide reduced pain, faster recovery, and fewer complications compared to electrocautery TE.
authors.affiliation: Department of Otorhinolaryngology, Päijät-Häme Central Hospital of Lahti, 15850 Lahti, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Silvola
authors.forename: Aarre
authors.initials: A
authors.lastname: Salonen
authors.forename: Jouko
authors.initials: J
authors.lastname: Nieminen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kokki
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D014068:Tonsillectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods