Tonsillectomy in children: thermal welding system versus cold dissection technique
Objectives:Tonsillectomy is one of the most frequently applied and the oldest surgical procedures in otorhinolaryngology. While the cold dissection method (CDM) is the one of the most frequent techniques, new methods are being generated to improve the outcome of tonsillectomy. Thermal welding system...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayincilik
2009-06-01
|
| Series: | Turkish Archives of Otorhinolaryngology |
| Subjects: | |
| Online Access: |
http://turkarchotolaryngol.net/archives/archive-detail/article-preview/tonsillectomy-in-children-thermal-welding-system-v/43526
|
| _version_ | 1797918893279281152 |
|---|---|
| author | Özgür Yiğit Zeynep Alkan Çakır Ayfle Sezim Şişman Emin Karaman |
| author_facet | Özgür Yiğit Zeynep Alkan Çakır Ayfle Sezim Şişman Emin Karaman |
| author_sort | Özgür Yiğit |
| collection | DOAJ |
| description | Objectives:Tonsillectomy is one of the most frequently applied and the oldest surgical procedures in otorhinolaryngology. While the cold dissection method (CDM) is the one of the most frequent techniques, new methods are being generated to improve the outcome of tonsillectomy. Thermal welding system (TWS) is the most recent surgical method. In this prospective, randomized, single-blind, single surgeon study, TWS and CDM are compared with respect to per/postoperative parameters under the light of current literature.Methods:Fifty four patients were included in this study. Patients were randomly assigned to TWS or CDM groups. Twenty four patients in the TWS group (mean age 10.38 years) and thirty patients in CDM group (mean age 10.77) underwent tonsillectomy under general anesthesia. During surgery; operating time, intraoperative bleeding and postoperative pain, return of phonation, the initiation time of oral intake and complication rates were evaluated. Patients who had adenoidectomy and similar procedures in addition to tonsillectomy and patients with hemorrhagic diathesis were excluded from the study.Results:While mean operative time was 13.92±3.66 minutes for TWS, the time for CDM was 37.80±14.13 minutes (p<0.001). Mean intraoperative blood loss was 6.33±4.27 ml for TWS and 30.17±10.95 ml for CDM (p<0.001). In both groups, from the first postoperative day on, complaints of pain decreased stepwise. However from the first to the fifth postoperative days (p<0.05) higher pain scores were observed in the TWS group than the CDM group. Within our findings, mean time to recovery of normal phonation was 5.42±1.25 days for TWS and 2.37±1 days for the CDM group (p<0.001). Time to recovery of normal oral intake activity was not significantly different between the two groups (5.9±0.99 days in TWS group, 5.5±1.35 days in CDM group) (p>0.05). Primary hemorrhage occurred in 3 patients of the TWS and 10 patients of the CDM group. Secondary postoperative hemorrhage was seen in 1 patient of the TWS group.Conclusion:TWS provides a lesser intraoperative bleeding and decrease the operative time. However CDM offers better postoperative comfort. Because there are not adequate publications concerning this issue, it is necessary to design new comparative studies between tonsillectomy techniques to evaluate postoperative bleeding and patient comfort. |
| first_indexed | 2024-04-10T13:37:48Z |
| format | Article |
| id | doaj.art-503497b90fc347089202ea393a116c2f |
| institution | Directory Open Access Journal |
| issn | 2667-7474 |
| language | English |
| last_indexed | 2024-04-10T13:37:48Z |
| publishDate | 2009-06-01 |
| publisher | Galenos Yayincilik |
| record_format | Article |
| series | Turkish Archives of Otorhinolaryngology |
| spelling | doaj.art-503497b90fc347089202ea393a116c2f2023-02-15T16:11:20ZengGalenos YayincilikTurkish Archives of Otorhinolaryngology2667-74742009-06-01472778210.2399/tao.08.00513049054Tonsillectomy in children: thermal welding system versus cold dissection techniqueÖzgür Yiğit0Zeynep Alkan Çakır1Ayfle Sezim Şişman2Emin Karaman3 Department of Otolaryngology-Head and Neck Surgery, İstanbul Teaching and Research Hospital, İstanbul Department of Otolaryngology-Head and Neck Surgery, İstanbul Teaching and Research Hospital, İstanbul Department of Otolaryngology-Head and Neck Surgery, İstanbul Teaching and Research Hospital, İstanbul Department of Otorhinolaryngology&Head and Neck Surgery, Cerrahpafla Medical Faculty, İstanbul University, İstanbul Objectives:Tonsillectomy is one of the most frequently applied and the oldest surgical procedures in otorhinolaryngology. While the cold dissection method (CDM) is the one of the most frequent techniques, new methods are being generated to improve the outcome of tonsillectomy. Thermal welding system (TWS) is the most recent surgical method. In this prospective, randomized, single-blind, single surgeon study, TWS and CDM are compared with respect to per/postoperative parameters under the light of current literature.Methods:Fifty four patients were included in this study. Patients were randomly assigned to TWS or CDM groups. Twenty four patients in the TWS group (mean age 10.38 years) and thirty patients in CDM group (mean age 10.77) underwent tonsillectomy under general anesthesia. During surgery; operating time, intraoperative bleeding and postoperative pain, return of phonation, the initiation time of oral intake and complication rates were evaluated. Patients who had adenoidectomy and similar procedures in addition to tonsillectomy and patients with hemorrhagic diathesis were excluded from the study.Results:While mean operative time was 13.92±3.66 minutes for TWS, the time for CDM was 37.80±14.13 minutes (p<0.001). Mean intraoperative blood loss was 6.33±4.27 ml for TWS and 30.17±10.95 ml for CDM (p<0.001). In both groups, from the first postoperative day on, complaints of pain decreased stepwise. However from the first to the fifth postoperative days (p<0.05) higher pain scores were observed in the TWS group than the CDM group. Within our findings, mean time to recovery of normal phonation was 5.42±1.25 days for TWS and 2.37±1 days for the CDM group (p<0.001). Time to recovery of normal oral intake activity was not significantly different between the two groups (5.9±0.99 days in TWS group, 5.5±1.35 days in CDM group) (p>0.05). Primary hemorrhage occurred in 3 patients of the TWS and 10 patients of the CDM group. Secondary postoperative hemorrhage was seen in 1 patient of the TWS group.Conclusion:TWS provides a lesser intraoperative bleeding and decrease the operative time. However CDM offers better postoperative comfort. Because there are not adequate publications concerning this issue, it is necessary to design new comparative studies between tonsillectomy techniques to evaluate postoperative bleeding and patient comfort. http://turkarchotolaryngol.net/archives/archive-detail/article-preview/tonsillectomy-in-children-thermal-welding-system-v/43526 cold dissection methodthermal welding systemtonsillectomychildren. |
| spellingShingle | Özgür Yiğit Zeynep Alkan Çakır Ayfle Sezim Şişman Emin Karaman Tonsillectomy in children: thermal welding system versus cold dissection technique Turkish Archives of Otorhinolaryngology cold dissection method thermal welding system tonsillectomy children. |
| title | Tonsillectomy in children: thermal welding system versus cold dissection technique |
| title_full | Tonsillectomy in children: thermal welding system versus cold dissection technique |
| title_fullStr | Tonsillectomy in children: thermal welding system versus cold dissection technique |
| title_full_unstemmed | Tonsillectomy in children: thermal welding system versus cold dissection technique |
| title_short | Tonsillectomy in children: thermal welding system versus cold dissection technique |
| title_sort | tonsillectomy in children thermal welding system versus cold dissection technique |
| topic | cold dissection method thermal welding system tonsillectomy children. |
| url |
http://turkarchotolaryngol.net/archives/archive-detail/article-preview/tonsillectomy-in-children-thermal-welding-system-v/43526
|
| work_keys_str_mv | AT ozguryigit tonsillectomyinchildrenthermalweldingsystemversuscolddissectiontechnique AT zeynepalkancakır tonsillectomyinchildrenthermalweldingsystemversuscolddissectiontechnique AT ayflesezimsisman tonsillectomyinchildrenthermalweldingsystemversuscolddissectiontechnique AT eminkaraman tonsillectomyinchildrenthermalweldingsystemversuscolddissectiontechnique |