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Bipolar scissors versus cold dissection for pediatric tonsillectomy--a prospective, randomized pilot study.

V V Raut1, N Bhat, A R Sinnathuray

  • 1Department of Otolaryngology, Royal Victoria Hospital, Belfast, UK. rautvivek@hotmail.com

International Journal of Pediatric Otorhinolaryngology
|May 22, 2002
PubMed
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Bipolar scissors tonsillectomy significantly reduces surgical time and blood loss in children aged 10-16 compared to cold dissection. This method offers similar safety and morbidity rates for pediatric tonsillectomy.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery

Background:

  • Tonsillectomy is a common surgical procedure for recurrent or chronic tonsillitis.
  • Traditional cold dissection tonsillectomy has established outcomes but can be associated with significant blood loss and operative time.

Purpose of the Study:

  • To compare the efficacy and safety of bipolar scissors tonsillectomy versus cold dissection tonsillectomy in pediatric patients.
  • To evaluate intra-operative bleeding, operative time, post-operative pain, and complication rates.

Main Methods:

  • A prospective, randomized multiunit study involving 50 children aged 10-16 years undergoing tonsillectomy.
  • Patients were divided into two groups: bipolar scissors tonsillectomy and cold dissection tonsillectomy.
  • Outcomes measured included blood loss, operative time, pain scores, and hemorrhage rates.

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Main Results:

  • Bipolar scissors tonsillectomy showed significantly lower median intra-operative blood loss (6 ml vs. 86 ml) and shorter median operative time (10.5 min vs. 14.5 min) compared to cold dissection (P<0.001).
  • No statistically significant difference in post-operative pain scores was observed between the two methods (P>0.05).
  • Overall reactionary and secondary hemorrhage rates were 4% and 14%, respectively, and were not affected by the surgical method.

Conclusions:

  • Bipolar scissors tonsillectomy is a safe and effective alternative for pediatric tonsillectomy in children aged 10-16 years.
  • The technique offers significant advantages in reduced surgical time and blood loss compared to cold dissection.
  • These benefits suggest bipolar scissors tonsillectomy is a favorable option for pediatric tonsillectomy, particularly in this age group.