Histological analysis of tonsillectomies: relationship with surgical technique, post-operative pain and haemorrhage.
OBJECTIVE
There is no consensus on the optimal technique to decrease post-tonsillectomy morbidity. Histopathological analysis can estimate collateral tissue damage. This study compared histological findings for tonsils removed by cold or electrocautery dissection and their relationship with post-operative complications.


METHODS
Two adult out-patient groups were included in the study: 37 who underwent cold dissection and 37 who underwent electrocautery dissection. Histological analysis was used to assess tissue damage.


RESULTS
Tissue damage was significantly higher in the electrocautery dissection group (p = 0.002), as were the number of emergency department visits (p = 0.01) and the need for supplemental analgesia (p = 0.013). Patients in the cold dissection group experienced less pain (p = 0.001) and fewer secondary haemorrhage episodes.


CONCLUSIONS
Cold dissection produces less tissue damage, which is associated with lower incidence of complications. This study suggests that cold dissection is the technique of choice for tonsillectomy.
Department of Ambulatory Surgery,Hospital Universitario Central de Asturias,University of Oviedo,Spain.
M L
ML
Magdalena
Department of Ambulatory Surgery,Hospital Universitario Central de Asturias,University of Oviedo,Spain.
A
A
Solé
Department of Pathology,Hospital Universitario Central de Asturias,University of Oviedo,Spain.
V
V
Blanco
Department of Otolaryngology,Hospital Universitario Central de Asturias,University of Oviedo,Spain.
J P
JP
Rodrigo
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D004210:Dissection / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology*; D014066:Palatine Tonsil / Q000473:pathology*; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods*; D055815:Young Adult
Analgesia; Dissection; Electrocoagulation; Hemorrhage; Pain; Tonsillectomy