A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Background: The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.Methods: A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups. Results: Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value <0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant. Conclusions: This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period.

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Application of platysma muscle suture after thyroidectomy

Journal of Surgery and Trauma ◽

10.32592/jsurgery.2020.8.4.103 ◽

2020 ◽

pp. 147-150

Keyword(s):

Postoperative Pain ◽

Wound Infection ◽

Intervention Group ◽

Control Group ◽

P Value ◽

Platysma Muscle ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean ◽

Length Of Hospitalization

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

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Advantages of Tonsillectomy done under Local Anesthesia compared to General Anesthesia in Adults

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1129 ◽

2013 ◽

Vol 4 (1) ◽

pp. 13-18 ◽

Cited By ~ 1

Author(s):

Sudhir Naik ◽

Sarika S Naik ◽

S Ravishankara ◽

Mohan K Appaji ◽

MK Goutham ◽

...

Keyword(s):

Blood Loss ◽

General Anesthesia ◽

Local Anesthesia ◽

Case Series ◽

Limited Resources ◽

Pain Scores ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean ◽

Head Neck

ABSTRACT Background/Objectives Tonsillectomy using local anesthesia (local tonsillectomy) is a safe and effective alternative to general anesthesia in the healthy cooperative teenage or adult patients. Blood loss, morbidity, complications and patient satisfaction were better in some studies with tonsillectomies done under general anesthesia. Design Comparative case series analysis study of two groups of patients who underwent tonsillectomies under local and general anesthesia during the study period of 57 months from March 2007 to December 2011. Materials and methods Overall 1,349 cases of tonsillectomies done for chronic tonsillitis were included under the study. Three hundred and sixty-seven cases operated under general anesthesia and 982 cases operated under local anesthesia were compared. The parameters compared were duration of surgery, blood loss and the mean pain visual analog score. Results Significant difference in duration of surgery, blood loss during surgery and visual analog scale (VAS) pain scores were seen in the two groups with local anesthesia scoring over general anesthesia. Conclusion Tonsillectomy under local anesthesia is a good alternate for the procedure under general anesthesia with limited resources and in cooperative adults. How to cite this article Naik SM, Naik SS, Ravishankara S, Appaji MK, Goutham MK, Devi NP, Mushannavar AS. Advantages of Tonsillectomy done under Local Anesthesia compared to General Anesthesia in Adults. Int J Head Neck Surg 2013;4(1):13-18.

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Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

10.21203/rs.3.rs-582705/v1 ◽

2021 ◽

Author(s):

Ameer A. Alaqeedy ◽

Rasheed Ali Rashid ◽

Raid M. Al-Ani

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Comparative Study ◽

Diode Laser ◽

Operative Time ◽

Postoperative Bleeding ◽

P Value ◽

Intraoperative Blood Loss ◽

Laser Technique ◽

Significant Difference

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.

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Coblation versus bipolar electrocautery tonsillectomy: a comparative study in children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213284 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1482

Author(s):

G. Abhinav Kiran ◽

Y. Prabhakara Rao ◽

B. Shanthi Priyanka ◽

Supreety .

Keyword(s):

Blood Loss ◽

Surgical Techniques ◽

Operation Time ◽

Postoperative Recovery ◽

Intraoperative Blood Loss ◽

Medical Sciences ◽

Secondary Hemorrhage ◽

Pain Scores ◽

Significant Difference ◽

The Mean

Background: Tonsillectomy is a commonly done surgery by ENT surgeons all over the world. There are many surgical techniques to do this surgery. This study is aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy.Methods: This prospective study was carried out on 60 patients that underwent tonsillectomy over 2 years from February 2019 to January 2021 in Mallareddy Institute of Medical Sciences, Suraram, Hyderabad. The patients were equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 4-15 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding.Results: There was no statistically significant difference in the mean operation time and intra operative blood loss between the coblation group and bipolar electrocautery group There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. 1 episode of secondary hemorrhage was recorded in bipolar electrocautery tonsillectomy.Conclusions: Bipolar electrocautery tonsillectomy offers the same operative speed, similar intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.

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Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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ELECTIVE MIDLINE LAPAROTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.01.1869 ◽

2011 ◽

Vol 18 (01) ◽

pp. 106-111

Author(s):

ARSALAN SIRAJ ◽

ATHAR ABBAS SHAH GILANI ◽

MUHAMMAD FAROOQ DAR ◽

Sohail Raziq

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Wound Infection ◽

Visual Analogue Score ◽

P Value ◽

Midline Laparotomy ◽

Pain Scores ◽

Group A ◽

Insignificant Difference ◽

Group B

Objectives: To compare the diathermy incision with scalpel incision in patients undergoing midline elective laparotomy. Design of Study: A prospective, experimental comparative study. Place and Duration: Department of surgery, PNS Shifa Karachi, from March 2007 to June 2008. Patients and Methods: A total of 100 patients were included in the study, and equally divided into 2 groups. Group A received scalpel incision while in group B diathermy was employed to incise all layers. Peroperative parameters including, incision time and blood loss were calculated. Postoperatively, pain was assessed by visual analogue score and wound infection documented. Results: Both groups included fifty patients each out of the total 44 females and 56 were males, with similar gender preposition in both the groups. Mean age of patients in scalpel group was 48.78 (±14.47) while it was 44.92 (±15.87) in diathermy group. The mean incision related blood loss in Scalpel group was 1.53 (±0.20) ml/cm2 and in Diathermy group was 1.43 (±0.20) ml/cm2, showing significantly less bleeding in diathermy group (p-value= 0.014). Diathermy group, with incision related time of 6.20 sec/cm2 (±0.97 sec/cm2), was significantly quicker (p-value= 0.003) than scalpel incision, with incision time of 6.76 sec/cm2 (±0.84 sec/cm2). Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups. Conclusions: Diathermy, employed for midline laparotomy, is quicker and hemostatic, compared to the scalpel. The two are, however, similar in terms of wound infection and postoperative pain.

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A clinico-surgical outcome of vaginal hysterectomy with or without hydro dissection: a Quasi experimental study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183774 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3668

Author(s):

Kirti M. Hurakadli ◽

L. L. Pujari ◽

Prashant G.

Keyword(s):

Blood Loss ◽

Vaginal Hysterectomy ◽

Minimal Invasive Surgery ◽

Minimal Invasive ◽

Intraoperative Blood Loss ◽

Duration Of Surgery ◽

Quasi Experimental ◽

Abdominal Route ◽

The Mean ◽

Lower Morbidity

Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.

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Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

Journal of Clinical Urology ◽

10.1177/2051415818759366 ◽

2018 ◽

Vol 12 (3) ◽

pp. 239-245

Author(s):

Alexios Dosis ◽

Blessing Dhliwayo ◽

Patrick Jones ◽

Iva Kovacevic ◽

Jonathan Yee ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Radical Cystectomy ◽

Length Of Hospital Stay ◽

Categorical Variables ◽

Complication Rates ◽

Intraoperative Blood Loss ◽

Single Centre ◽

Significant Difference ◽

Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

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Conventional Dissection and Bipolar Electrocauterization Methods of Tonsillectomy: A Comparative Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40429 ◽

2022 ◽

Vol 19 (1) ◽

pp. 77-80

Author(s):

Anshu Sharma ◽

Shama Bhandari ◽

Dhundi Raj Paudel

Keyword(s):

Blood Loss ◽

Comparative Study ◽

Pain Intensity ◽

Postoperative Blood Loss ◽

Intraoperative Blood Loss ◽

Advantages And Disadvantages ◽

Post Operative Pain ◽

Significant Difference ◽

The Mean ◽

Dissection Method

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.

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Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

10.21203/rs.3.rs-129591/v1 ◽

2021 ◽

Author(s):

Pei-Chi Wu ◽

Bor-Ching Sheu ◽

Kuan-Ju Huang ◽

Su-Cheng Huang ◽

Wen-Chun Chang

Keyword(s):

Blood Loss ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Tertiary Referral Center ◽

Experienced Surgeon ◽

Minimally Invasive Surgical ◽

Postoperative Hematoma ◽

Significant Difference ◽

The Mean ◽

Glove Port

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

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