Effect of gold laser energy delivery on postoperative adenotonsillectomy complications

This study aimed to determine if the energy delivered by the Gold laser impacted postoperative complication rates after adenoidectomy, tonsillectomy, or adenotonsillectomy.

A retrospective chart review identified 420 patients who met the criteria within the last five years. Indications for the surgeries included recurrent tonsillitis, obstructive sleep apnea, sleep-disordered breathing, adenoiditis, peritonsillar abscess, and other indications. The relationship between the energy delivered (kJ) and various complications such as bleeding, pain, dehydration, readmission, emergency center visits, and clinic calls was evaluated.

There was a significant correlation between higher kJ delivered and the incidence of major bleeding requiring cauterization in the operating room (p = 0.0311). In addition, emergency center visits (p = 0.0131) and readmission (p = 0.0210) showed a significant correlation with the amount of energy (kJ) delivered. Furthermore, higher energy correlated to higher maximum post-operative pain scores (p = 0.0302). Attendings displayed a different pattern of energy delivery compared to residents (p < 0.0001), which also differed by PGY (p < 0.0001).

There are significant correlations between higher energy delivered in kJ using the Gold laser and less desirable post-operative results. In addition, residents tend to utilize higher energy levels than attendings, but this trend tapers off in the 4th and 5th years. Clinicians utilizing the Gold laser during these procedures should be mindful of the amount of kJ they use.