Coblation adenotonsillectomy in children

Abstract

Objective: To determine re-admission rate for post-tonsillectomy pain; the primary and secondary post-tonsillectomy bleeding rate; the percentage requiring control of post-tonsillectomy bleeding in children undergoing coblation tonsillectomy.

Study design: A descriptive study.

Place and duration of study: Royal Hospital for Sick Children (Yorkhill Hospital) between 2004 and 2006.

Methodology: All patients who underwent tonsillectomy with or without adenoidectomy by coblation technique. Patients were identified from operation theatre log book and electronic data base of theatre activity. The hospital case notes were reviewed retrospectively to collect data, regarding demographics, indication and type of surgery, grade of operating surgeon, duration of hospital stay, re-attendance and re-admission, and management of complications.

Results: A total of 106 children; males (n = 53, 50%), females (n = 53, 50%) with a mean age 6.3 years underwent surgery using coblation technique. Thirty-one percent had a tonsillectomy while 69% underwent an adenotonsillectomy. Of these, 48% had history of recurrent tonsillitis, 43% had obstructive sleep apnoea and 9% suffered predominantly from obstructive symptoms. Eighty-two percent of patients were discharged on the first postoperative day. Only one patient had primary bleeding requiring re-operation. After discharge, 7 patients (6.7%) were re-admitted with secondary bleeding, 3 (2.8%) of whom were taken back to theatre to control the bleeding under general anaesthesia.

Conclusion: Coblation tonsillectomy is a useful technique in having a low primary and secondary bleeding rates in children undergoing tonsillectomy and adenotonsillectomy.