Bipolar diathermy-assisted coblation really affects post-tonsillectomy haemorrhage rate and white membrane in paediatric tonsillectomy

Abstract

Bipolar diathermy-assisted coblation really affects post-tonsillectomy haemorrhage rate and white membrane in paediatric tonsillectomy.

Objective: this study aimed to evaluate the effect of bipolar diathermy-assisted coblation on post-tonsillectomy haemorrhage (PTH) rate, operation time, the volume of blood loss during surgery, the time needed to return to a regular diet and the relationship between the thickness of the white membrane of tonsil fossa and the degree of postoperative pain in paediatric tonsillectomy.

Methods: a total of 1684 patients subjected to tonsillectomy (TE) were enrolled in this study from June 2013 to December 2015. They were randomly divided into a coblation tonsillectomy (control) group and a bipolar diathermy- assisted coblation tonsillectomy (intervention) group. The surgeon reported data concerning the techniques, primary and second PTH, surgery time, the volume of blood loss during surgery, the time needed to return to a regular diet, the thickness of the white membrane of tonsil fossa and the degree of postoperative pain.

Results: complete data concerning the technique employed for tonsillectomy as applied in all patients: early and late PTH, surgery time, volume of blood loss during surgery, time needed to resume a regular diet, white membrane thickness of tonsil fossa and postoperative pain degree were collected in the Otorhinolaryngology Department of the First Hospital in Qinhuangdao of China. In the control group, the primary and secondary PTH values were 2.6% and 5.8%, whereas in the intervention group, these values were 0.35% and 1.8%, respectively. The primary PTH rate in the control group was 7.43 times higher than that in the intervention group; the secondary PTH rate in the control group was 3.22 times higher than that in the intervention group (p <0.05). We found that the thickness of the white membrane of the homeostasis area of tonsillar fossa in the intervention group was thinner than that of the control group. The intraoperative blood loss in the control group and intervention group was 3.3 ? 1.6 mL and 2.1 ? 2.9 mL, respectively (p < 0.05). Surgery times in the control and intervention group was 17.4 ? 5.1 min and 16.3 ? 4.8 min, respectively (p < 0.05). The period required for resuming a regular diet in the control and intervention group was 5.4 ? 3.4 and 5.1 ? 6.2 days, respectively (p > 0.05).

Conclusion: bipolar diathermy-assisted coblation can reduce post-tonsillectomy haemorrhage (PTH) rate, operation time, the volume of blood loss during surgery and the white membrane thickness of tonsillar fossa. The thickness of the white membrane of tonsil fossa is positively correlated with postoperative pain degree. The time needed to resume a regular diet showed no significant differences between the two groups.