Endoscopic Monitorization of Pediatric Tonsillectomy Bed After Cold Knife and Ligasure Technique

This study compares cold knife and Ligasure tonsillectomy techniques in pediatric patients, evaluating operation time, pain, complications, and short-term recovery outcomes.

Ninety-one patients who underwent tonsillectomy between March 2023 and March 2024 were randomly divided into 2 groups: 45 patients operated with the Ligasure technique and 46 underwent the cold knife technique. The pain scores were evaluated using the Wong-Baker FACES Pain Rating Scale on the first, third, and seventh days post-tonsillectomy. Wound healing was assessed through endoscopic image of the tonsillar surgical bed on the postoperative seventh day through analyzing and scoring the pinkish membrane. In addition, the incidence of bleeding was examined in each group.

The operative time was significantly shorter in the Ligasure group ( P <0.001). Postoperative pain decreased over time in both groups ( P <0.001), with no significant difference between the Ligasure and cold knife techniques ( P =0.393). There were no cases of primary hemorrhage in either group; however, secondary hemorrhage was observed in 3 patients from the Ligasure group and 2 patients from the cold knife group. Wound healing >50% of the tonsillar bed area was noted in 47.3% of all patients, with 24 patients in the Ligasure group, compared with 19 patients in the cold knife group ( P =0.250).

Our findings indicate that Ligasure tonsillectomy has a shorter operative time, similar pain levels, and slightly better wound healing compared with the cold knife technique. The Ligasure tonsillectomy might be an efficient, secure, and rapid method.