title: Postoperative tonsillectomy bleeding complications in children: A comparison of three surgical techniques.
abstract: Stated in the Null form: There will be no difference in primary or secondary hemorrhage rate in children undergoing tonsillectomy or adenotonsillectomy across three surgical techniques: PEAK Plasmablade, electric monopolar cautery, coblation.
  
  
  METHODS
  Retrospective chart analysis.
  
  
  METHODS
  Academic Medical Center: Children's Hospital.
  
  
  METHODS
  Electronic chart data were collected from patient's age 2-18 years who underwent tonsillectomy, with or without adenoidectomy, at a tertiary pediatric hospital between June 2011 to May 2013 by electric monopolar cautery, coblation, or PEAK PlasmaBlade. Treatment outcomes following each of these surgical approaches, relative to rate of post-operative primary and secondary bleeding, hospital admission, and emergency department visits were compared.
  
  
  RESULTS
  A total of 1780 patients that had tonsillectomy or adenotonsillectomy were evaluated. There was a significant difference in bleed rate by age with older patients having more bleeding post-procedure than their younger counterparts. There was also a difference in bleeding frequency by diagnosis. Patients with a diagnosis of OSA were less likely to experience a postoperative bleed than children with either recurrent tonsillitis or both. Significance was evident between post-op hemorrhage rate and instrumentation (χ(2) = 11.17, df = 2, p = 0.004). The majority of bleeds occurred with coblation (58.9%), while PEAK had only 17.8% and cautery 23%.
  
  
  CONCLUSIONS
  The null hypothesis was rejected. That is, PEAK PlasmaBlade was safe and effective, with statistically less postoperative bleeding and ED visits, especially when compared to coblation techniques. Coblation patients had the highest rates of postoperative bleeding.
authors: Detroit Medical Center & Children's Hospital of Michigan, Department of Otolaryngology, Head & Neck Surgery, Detroit, MI, USA.
authors: Jennifer C
authors: JC
authors: Lane
authors: Detroit Medical Center & Children's Hospital of Michigan, Department of Otolaryngology, Head & Neck Surgery, Detroit, MI, USA. Electronic address: voicedx@yahoo.com.
authors: James
authors: J
authors: Dworkin-Valenti
authors: University of Massachusetts, College of Nursing, Amherst, MA, USA.
authors: Lisa
authors: L
authors: Chiodo
authors: Detroit Medical Center & Children's Hospital of Michigan, Department of Otolaryngology, Head & Neck Surgery, Detroit, MI, USA.
authors: Michael
authors: M
authors: Haupert
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods; D000293:Adolescent; D002425:Cautery / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D014069:Tonsillitis / Q000601:surgery; D016896:Treatment Outcome
keywords: Adenotonsillectomy; Bleeding; Coblation; Complications; Electro-cautery; Hemorrhage; PEAK plasma blade; Tonsillectomy