title: Guillotine versus dissection tonsillectomy: randomised, controlled trial.
abstract: OBJECTIVE
  This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'.
  
  
  METHODS
  A single centre, randomised, controlled trial.
  
  
  METHODS
  One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.
  
  
  RESULTS
  Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.
  
  
  CONCLUSIONS
  This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.
authors.affiliation: Department of Otolaryngology, Poole Hospital NHS Foundation Trust, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Frampton
authors.forename: M J A
authors.initials: MJ
authors.lastname: Ward
authors.forename: V S
authors.initials: VS
authors.lastname: Sunkaraneni
authors.forename: H
authors.initials: H
authors.lastname: Ismail-Koch
authors.forename: Z A
authors.initials: ZA
authors.lastname: Sheppard
authors.forename: R J
authors.initials: RJ
authors.lastname: Salib
authors.forename: P K
authors.initials: PK
authors.lastname: Jain
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology*; D014066:Palatine Tonsil / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery*; D016896:Treatment Outcome