A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy
Abstract Objective The aim of this study was to compare intraoperative blood loss, postoperative pain, post‐tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation and monopolar electrocautery in children. Materials and methods This study inclu...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.789 |
| _version_ | 1828794045034397696 |
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| author | Zhengcai Lou Zihan Lou Tian Lv Zhengnong Chen |
| author_facet | Zhengcai Lou Zihan Lou Tian Lv Zhengnong Chen |
| author_sort | Zhengcai Lou |
| collection | DOAJ |
| description | Abstract Objective The aim of this study was to compare intraoperative blood loss, postoperative pain, post‐tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation and monopolar electrocautery in children. Materials and methods This study included 293 patients aged 6–15 years planned to undergo extracapsular tonsillectomy. Data on estimated blood loss, postoperative pain score, operation time, PTH, and the cost of disposable equipment were collected. Results Coblation extracapsular tonsillectomy was associated with significantly lower mean pain scores than monopolar technique on postoperative days 1 (p <.001) and 2 (p = 0.02). However, the pain score was similar between the groups at all other time points. The monopolar group had a significantly shorter operation time compared to the coblation group (11.09 ± 7.53 vs. 17.12 ± 4.29 min, p <.001). Intraoperative estimated blood loss was not significantly different between the groups (p = .43).The cost of extracapsular tonsillectomy was significantly lower in the monopolar compared to the coblation group (US$ 28.18 vs. US$ 430.48, p <.001). PTH occurred in 17 patients (5.80%) and required a second surgery. Secondary PTH occurred in 6.16% (9/146) and 0.68% (1/147) of patients in the coblation and monopolar groups, respectively (p <.001). The PTH was significantly higher in the tonsillitis compared to in the tonsillar hypertrophy (12.37% vs. 2.55%, p = .002), However, the difference of PTH was not significant among mean pain scores subgroups. Of the 17 patients with PTH, the lower pole, middle portion, and upper pole were involved in 15 (88.24%), 2 (11.76%), and 0 cases, respectively. Conclusions Coblation and novel monopolar electrocautery extracapsular tonsillectomy are associated with similar postoperative pain scores except on postoperative days 1 and 2. However, monopolar technique offers significant advantages over coblation method with less operative time, decreased secondary PTH, and cost. Level of Evidence: NA. |
| first_indexed | 2024-12-12T03:38:05Z |
| format | Article |
| id | doaj.art-8a42190752e249c39984386b0dc2dc32 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-12T03:38:05Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-8a42190752e249c39984386b0dc2dc322022-12-22T00:39:45ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-06-017370771410.1002/lio2.789A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomyZhengcai Lou0Zihan Lou1Tian Lv2Zhengnong Chen3Department of Otorhinolaryngology Yiwu Central Hospital Yiwu city Zhejiang Province ChinaDepartment of Otolaryngology‐Head and Neck Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaDepartment of Otorhinolaryngology Yiwu Central Hospital Yiwu city Zhejiang Province ChinaDepartment of Otolaryngology‐Head and Neck Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaAbstract Objective The aim of this study was to compare intraoperative blood loss, postoperative pain, post‐tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation and monopolar electrocautery in children. Materials and methods This study included 293 patients aged 6–15 years planned to undergo extracapsular tonsillectomy. Data on estimated blood loss, postoperative pain score, operation time, PTH, and the cost of disposable equipment were collected. Results Coblation extracapsular tonsillectomy was associated with significantly lower mean pain scores than monopolar technique on postoperative days 1 (p <.001) and 2 (p = 0.02). However, the pain score was similar between the groups at all other time points. The monopolar group had a significantly shorter operation time compared to the coblation group (11.09 ± 7.53 vs. 17.12 ± 4.29 min, p <.001). Intraoperative estimated blood loss was not significantly different between the groups (p = .43).The cost of extracapsular tonsillectomy was significantly lower in the monopolar compared to the coblation group (US$ 28.18 vs. US$ 430.48, p <.001). PTH occurred in 17 patients (5.80%) and required a second surgery. Secondary PTH occurred in 6.16% (9/146) and 0.68% (1/147) of patients in the coblation and monopolar groups, respectively (p <.001). The PTH was significantly higher in the tonsillitis compared to in the tonsillar hypertrophy (12.37% vs. 2.55%, p = .002), However, the difference of PTH was not significant among mean pain scores subgroups. Of the 17 patients with PTH, the lower pole, middle portion, and upper pole were involved in 15 (88.24%), 2 (11.76%), and 0 cases, respectively. Conclusions Coblation and novel monopolar electrocautery extracapsular tonsillectomy are associated with similar postoperative pain scores except on postoperative days 1 and 2. However, monopolar technique offers significant advantages over coblation method with less operative time, decreased secondary PTH, and cost. Level of Evidence: NA.https://doi.org/10.1002/lio2.789coblationmonopolar electrocauterypain scorespost‐hemorrhage tonsillectomytonsillectomy |
| spellingShingle | Zhengcai Lou Zihan Lou Tian Lv Zhengnong Chen A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy Laryngoscope Investigative Otolaryngology coblation monopolar electrocautery pain scores post‐hemorrhage tonsillectomy tonsillectomy |
| title | A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy |
| title_full | A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy |
| title_fullStr | A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy |
| title_full_unstemmed | A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy |
| title_short | A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy |
| title_sort | prospective randomized single blind study comparing coblation and monopolar extracapsular tonsillectomy |
| topic | coblation monopolar electrocautery pain scores post‐hemorrhage tonsillectomy tonsillectomy |
| url | https://doi.org/10.1002/lio2.789 |
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