Surgical technique and post-tonsillectomy hemorrhage: a single institution's retrospective study

Post-tonsillectomy hemorrhage is one of the most common complications of tonsillectomy. The rate varies with different methods. We retrospectively analyzed patients who underwent tonsillectomy in a period of two years. Two surgical methods, cold dissection and microscopically assisted bipolar tonsillectomy, were compared. 1007 patients were included in the study. Postoperative hemorrhage occurred in 116 patients (11.5 %). By the cold dissection method, postoperative bleeding was noted in 86 patients (10.9 %), while by the microscopic bipolar method in 30 patients (13.9 %). A surgical hemostasis was required in 47 patients (5.9 %) and 17 patients (7.9 %), respectively. Concerning the time of occurrence of the first postoperative bleeding episode, we found that it occurred mainly on day 6 by the cold dissection technique (median = 6, mean = 5.84, SD = 3.30), whereas by the bipolar technique the first episode occurred on day 5 (median = 5, mean = 5.27, SD = 2.85). However, a statistical analysis did not show a significant difference. In conclusion, our study did not show a significant difference concerning the prevalence or the postoperative day of occurrence of the first bleeding episode after tonsillectomy when comparing the two methods, but recommendations concerning the duration of the in-hospital stay could be made. Each institution should perform its own individualized statistics concerning the occurrence of postoperative bleeding and should use a standardized documentation protocol. Level of evidence 3b.