Cold/cold vs. bipolar dissection tonsillectomy: A surgeon‐controlled study of 400 cases

Cold/cold vs. bipolar dissection tonsillectomy: A surgeon‐controlled study of 400 cases KeypointsSurgeon‐controlled study of 200 cold/cold and 200 hot/hot tonsillectomy cases in one institution.Hot/hot resulted in higher overall rates of early and late post‐tonsillectomy haemorrhage and return to theatre when compared to cold/cold methods.Bipolar diathermy tonsillectomy resulted in a statistically significant higher rate of secondary post‐tonsillectomy haemorrhage than cold‐steel of nearly 3 times.Trainee surgeons performed better in bipolar haemostasis than cold‐steel dissection with regard to postoperative morbidity.With continued use of cold‐steel tonsillectomy methods in both junior and senior surgeons, it is hoped that the rates of PTH and RTT will continue to improve.INTRODUCTIONTonsillectomy represents 40% of the procedures performed in otolaryngology departments; equivalent to 45 000 tonsillectomies in the UK each year.The tonsillectomy procedure consists of 2 phases: tonsil excision and haemostasis, which can be classified as “hot” or “cold.”Hot Excision: Bipolar diathermy involves high‐frequency electric current being applied directly to the tonsil tissue from forceps.Cold Excision: Steel dissection involves an incision being made in the mucosa with scissors and mobilisation of tonsil using dissecting forceps.Hot Haemostasis: Diathermy heat coagulates vessels within tissue.Cold Haemostasis: Swabs control initial then ligatures control residual bleeding.A combination of techniques can be employed to create an entirely hot, cold or combined approach. Bipolar diathermy is used http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Otolaryngology Wiley

Cold/cold vs. bipolar dissection tonsillectomy: A surgeon‐controlled study of 400 cases

Loading next page...
 
/lp/wiley/cold-cold-vs-bipolar-dissection-tonsillectomy-a-surgeon-controlled-gMXkM20RW0
Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 John Wiley & Sons Ltd
ISSN
1749-4478
eISSN
1749-4486
D.O.I.
10.1111/coa.13057
Publisher site
See Article on Publisher Site

Abstract

KeypointsSurgeon‐controlled study of 200 cold/cold and 200 hot/hot tonsillectomy cases in one institution.Hot/hot resulted in higher overall rates of early and late post‐tonsillectomy haemorrhage and return to theatre when compared to cold/cold methods.Bipolar diathermy tonsillectomy resulted in a statistically significant higher rate of secondary post‐tonsillectomy haemorrhage than cold‐steel of nearly 3 times.Trainee surgeons performed better in bipolar haemostasis than cold‐steel dissection with regard to postoperative morbidity.With continued use of cold‐steel tonsillectomy methods in both junior and senior surgeons, it is hoped that the rates of PTH and RTT will continue to improve.INTRODUCTIONTonsillectomy represents 40% of the procedures performed in otolaryngology departments; equivalent to 45 000 tonsillectomies in the UK each year.The tonsillectomy procedure consists of 2 phases: tonsil excision and haemostasis, which can be classified as “hot” or “cold.”Hot Excision: Bipolar diathermy involves high‐frequency electric current being applied directly to the tonsil tissue from forceps.Cold Excision: Steel dissection involves an incision being made in the mucosa with scissors and mobilisation of tonsil using dissecting forceps.Hot Haemostasis: Diathermy heat coagulates vessels within tissue.Cold Haemostasis: Swabs control initial then ligatures control residual bleeding.A combination of techniques can be employed to create an entirely hot, cold or combined approach. Bipolar diathermy is used

Journal

Clinical OtolaryngologyWiley

Published: Jan 1, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial