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CO2-Lasertonsillotomy Under Local Anesthesia in Adults

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Post-tonsillectomy hemorrhage--some facts will never change.

Jochen P Windfuhr¹, Berit C Verspohl, Yue-Shih Chen

¹Department of Otorhinolaryngology, Plastic Head and Neck Surgery, Kliniken Maria Hilf Mönchengladbach, Sandradstr. 43, 41061, Mönchengladbach, Germany, jochen.windfuhr@mariahilf.de.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

|April 17, 2014

Summary

Replacing bipolar coagulation with suture ligation for tonsillectomy hemostasis did not significantly alter overall bleeding rates. However, the method of hemostasis impacted the timing of bleeding, with suture ligation increasing primary bleeding and bipolar coagulation increasing secondary bleeding.

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Area of Science:

Otolaryngology
Surgical Complications
Hemostasis Techniques

Background:

Post-tonsillectomy hemorrhage (PTH) is a significant complication.
Hemostasis methods in tonsillectomy (TE) may influence bleeding rates.
Suture ligation is an alternative to bipolar coagulation for TE hemostasis.

Purpose of the Study:

To compare bleeding rates after tonsillectomy using bipolar coagulation versus suture ligation for hemostasis.
To investigate the impact of hemostasis method on primary and secondary bleeding after TE.
To analyze age and sex as factors in post-tonsillectomy hemorrhage.

Main Methods:

Retrospective chart review of patients undergoing tonsillectomy between April 2007 and April 2013.
Group A: Hemostasis achieved with bipolar coagulation (36 months).
Group B: Hemostasis achieved with intraoperative suture ligation (36 months).

Main Results:

Overall bleeding rates were similar between bipolar coagulation (5.2%) and suture ligation (4.5%) groups (p=0.317).
Primary bleeding (PB) was more frequent with suture ligation, while secondary bleeding (SB) was more frequent with bipolar coagulation (p=0.000).
No significant differences in repeated bleeding episodes or age-related incidence were observed between groups.

Conclusions:

Replacing bipolar coagulation with suture ligation for TE hemostasis did not significantly change overall bleeding rates.
The choice of hemostasis method influences the timing of bleeding (PB vs. SB).
Further research into microsurgical techniques and suture methods for TE is warranted.