title: [Austrian tonsil study part 3: surgical technique and postoperative haemorrhage after tonsillectomy].
abstract: BACKGROUND
  Risk factors for postoperative haemorrhage after tonsillectomy are discussed controversy. In the past years surgical techniques were considered a determining factor for post-tonsillectomy bleedings in several studies.
  
  
  METHODS
  In a prospective, multicentre study 9,405 patients--of whom 4,437 underwent tonsillectomy and were focused in this article--were evaluated during study -period of 9 months (1st October 2009 till 30th June 2010). Postoperative haemorrhage was defined as any bleeding episode after extubation and classified according to a 7 grade scheme.
  
  
  RESULTS
  Postoperative haemorrhage occurred in 14.4% (637/4,437) patients with 4.6% (204/4,437) requiring a return to theatre and 9.8% (433/4,437) experiencing minor bleedings. Bipolar techniques (with or without cold steel dissection) showed a haemorrhage risk of 16.8% (62/370). Severe bleedings occurred significantly more often with the use of bipolar techniques (8% compared to 4.6% severe bleedings for all operation techniques, p=0.003). In addition, Coblation® technique had a higher postoperative haemorrhage rate (23.5%, 12/51). However, minor bleedings occurred in the majority of patients operated with Coblation® technique (20% compared to 9.8% minor bleedings for all operation techniques, p<0.017).
  
  
  CONCLUSIONS
  Following the strict definition of postoperative haemorrhage, we found higher postoperative haemorrhage rates for bipolar techniques and Coblation® technique. The proportion of severe bleedings is higher for bipolar methods, whereas the proportion of minor bleedings is higher for Coblation® technique.
authors.affiliation: Klinische Abteilung für Allgemeine HNO, Universitätsklinik Graz, Graz, Österreich. stephanie@sarny.at
authors.forename: S
authors.initials: S
authors.lastname: Sarny
authors.forename: G
authors.initials: G
authors.lastname: Ossimitz
authors.forename: W
authors.initials: W
authors.lastname: Habermann
authors.forename: H
authors.initials: H
authors.lastname: Stammberger
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001317:Austria; D017115:Catheter Ablation / Q000379:methods; D002648:Child; D003430:Cross-Sectional Studies; D004210:Dissection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D014068:Tonsillectomy / Q000379:methods*