[Novel tonsillectomy technique]

Abstract

Introduction: Coblation (Co) is a relatively new technique, which may offer a better postoperative course after tonsillectomy than traditional techniques. The purpose of this study was to determine whether Co outperforms classic dissection. Coblation uses radiofrequency energy to excite the electrolytes in a saline solution, creating a precisely focused plasma. The plasma's energized particles have sufficient energy to break molecular bonds within tissue, causing the tissue to dissolve at temperatures between 40 degrees C and 70 degrees C.

Material and methods: A case-control study was conducted in which 26 patients undergoing Co tonsillectomy were matched concerning gender, age and the surgeon's charge with 26 patients undergoing classic tonsillectomy. Furthermore, to compare the rates of postoperative haemorrhage, we reviewed the health records of all patients undergoing Co (60 patients) and routine dissection tonsillectomy (403) at Roskilde County Hospital.

Results: Intraoperative bleeding was significantly lower in the Co group (median (MD) 5.0 ml; range (R) 1-32 ml) than in the control group (MD 10.0 ml; R 5-200 ml) (p < 0.0001). The median operation time was also significantly shorter for the Co group (23 min.; R 13-40 min. vs. 32 min.; R 21-63 min.; p = 0.002). Postoperatively, there was no significant difference between the two groups regarding pain scores, analgesics intake, time to return to work and normal diet or weight changes. Neither the primary (0% vs. 2%, p = 0.60) nor the secondary (3.3% vs. 2.5%, p = 0,66) haemorrhage rate was significantly different between Co and traditional tonsillectomy.

Conclusion: The intraoperative bleeding was lower and the surgery times were shorter in the Co group compared with classic dissection. There was no difference in the postoperative haemorrhage rate between the two tonsillectomy methods.