scholarly journals Incidence of haemorrhage after tonsillectomy

2012 ◽  
Vol 18 (1) ◽  
pp. 55-58
Author(s):  
Mohammad Shah Kamal ◽  
Rubina Farzana ◽  
Abu Hena Mohammad Parvez Humayun ◽  
AHM Zahurul Huq ◽  
Md Mostafizur Rahman
Keyword(s):  
Diclofenac Sodium ◽  
Bipolar Diathermy ◽  
Life Threatening ◽  
Secondary Haemorrhage ◽  
Common Operation ◽  
Mouth Wash ◽  
A Prospective Study ◽  
Dissection Technique ◽  
Cold Steel Dissection

Tonsillectomy is probably the most common operation performed by an Otolaryngologist. One of the most significant complications is post-operative haemorrhage. Episodes of post tonsillectomy haemorrhage are unpredictable and sometimes life threatening. The aim of the present study was to find out the incidence of reactionary haemorrhage after tonsillectomy. A prospective study was conducted at Shaheed Shamsuddin Ahmed Hospital, Sylhet from April 2010 to March 2011. We had selected 112 cases undergoing tonsillectomy. Tonsillectomy was done by cold steel dissection technique and bipolar diathermy haemostasis. Post operatively every patient was treated with pain killer (diclofenac sodium and paracetamol), antibiotics (amoxicillin and cloxacillin) and hydrogen peroxide mouth wash. Postoperative follow-up was done till the tonsillar fossa healed. The incidence of reactionary haemorrhage was 2.68%, primary and secondary haemorrhage was 0%. In our series haemorrhage (2.68%) was higher than that reported in most publications and may be due to inadequate per-operative haemostasis. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10415  Bangladesh J Otorhinolaryngol 2012; 18(1): 55-58

Effect of post-operative analgesia duration on post-tonsillectomy readmission rate: comparison of five-day and 14-day regime

2007 ◽  
Vol 121 (10) ◽  
pp. 968-972 ◽  
Author(s):  
Y M Takwoingi ◽  
M Shykhon ◽  
M Wake
Keyword(s):  
Readmission Rate ◽  
Operating Theatre ◽  
Bipolar Diathermy ◽  
Readmission Rates ◽  
Operating Technique ◽  
Significant Difference ◽  
Secondary Haemorrhage ◽  
A Prospective Study ◽  
Rate Comparison ◽  
Cold Steel Dissection

Objectives: To determine whether the introduction of a 14-day post-tonsillectomy analgesic regime would be associated with a statistically significant decrease in readmission rate.Method: A comparative study of tonsillectomy patients over two study periods. A retrospective review was undertaken of 342 patients (group one, five-day analgesic regime) who had undergone tonsillectomy. A prospective study was undertaken of 228 patients (group two, 14-day analgesic regime). The readmission rates for the two study periods were compared.Results: The median age of group one patients was 8.1 years (range, zero to 43 years). In this group, ‘cold steel’ dissection was performed in 177 patients (52 per cent) and bipolar dissection in 165 patients (48 per cent); seven patients suffered reactionary haemorrhage, all from the cold steel dissection group. The median age of group two patients was 8.0 years (range, one to 47 years). In this group, cold steel dissection was performed in 103 patients (45 per cent) and bipolar dissection in 125 patients (55 per cent); there were no cases of reactionary haemorrhage. The readmission rate for group one was 9.9 per cent (34 patients), with 2.1 per cent (seven patients) returning to the operating theatre for control of haemorrhage. In group two, 8.8 per cent (20 patients) were readmitted and 1.3 per cent (three patients) returned to the operating theatre. The main reason for readmission was secondary haemorrhage: 9.1 per cent from group one and 8.3 per cent from group two. No significant difference in readmission was found between the 5-day analgesia and the 14-day analgesia groups (p=0.443). However, there was a significant difference between the diathermy and cold steel dissection groups (p<0.001). Patients undergoing bipolar diathermy were almost six times more likely to be readmitted than those undergoing cold steel dissection (odds ratio 5.78). The average time to readmission after tonsillectomy did not significantly differ between the two groups.Conclusion: The post-tonsillectomy readmission rate was not affected by the duration of post-operative analgesia; however, operating technique did have an effect.

scholarly journals Capsular dissection technique for reducing recurrent laryngeal neuropraxia and temporary hypoparathyroidism after thyroidectomy: a single center experience

2021 ◽  
Vol 7 (7) ◽  
pp. 1111
Author(s):  
Dimple Sahni ◽  
Rajwant Kaur ◽  
Gagandeep Kaur ◽  
Sangeeta Aggarwal ◽  
Sanjeev Bhagat
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Single Center ◽  
Single Center Experience ◽  
Clinical Presentations ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
A Prospective Study ◽  
Dissection Technique ◽  
Nose And Throat

<p class="abstract"><strong>Background:</strong> Foreign bodies in aerodigestive tract is common, frequent, and sometime life threatening emergency for otorhinolaryngologists mainly in the paediatric group. The aims of the present study was to find the incidence of foreign bodies, in relation to demographic factors, type and sites of foreign bodies its clinical presentations and its management.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted on 100 cases coming to the ear, nose and throat (ENT) emergency and outpatient department (OPD). After thorough history, clinical examination, routine blood and urine investigations and urine done. Radiological examination was done to visualize the radio-opaque foreign body, and if the foreign body was not radio-opaque then computed tomography (CT) scan was done.  </p><p class="abstract"><strong>Results:</strong> Incidence of foreign was 67% in male than 33% in female. Mostly foreign bodies were in nose (49%), followed by oesophageal (31%), abdominal (14%), and bronchus (6%) respectively. 33% were totally asymptomatic, 25% with mucupurulent discharge from nose, dysphagia (16%), nasal obstruction (15%), and odynophagia (11%) respectively. Most of the foreign bodies were inorganic in nature, coin (42%), pearls (8.16%), and battery (6.45%). Among organic foreign bodies peanut was most common (33.33%), grains (10%). All foreign bodies were removed successfully with minimal morbidity and zero mortality.</p><p class="abstract"><strong>Conclusions:</strong> Present study suggested incidence was very common among male children, in rural background, with common asymptomatic presentation. With high index of suspicion, and proper and timely intervention all 100 cases were managed successfully. But still educating the parents about keeping such things away from kids prevent these incident.</p>

Paediatric tonsillectomy: bipolar electrodissection and dissection/snare compared

1995 ◽  
Vol 109 (8) ◽  
pp. 733-736 ◽  
Author(s):  
Y. T. Pang
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Operating Time ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Measurable Difference ◽  
Common Operation ◽  
A Prospective Study ◽  
Cold Dissection

AbstractTonsillectomy is a common operation in children performed by a variety of techniques. Recently we have introduced a modified form of electrodissection tonsillectomy using bipolar diathermy. A prospective study was designed to evaluate this technique against the conventional dissection/snare technique. Sixty children were entered into each section of the study (total 120 children). There is a statistically significant shorter operating time (mean 11.2 minutes) and lower intraoperative blood loss (mean 5 ml) using the bipolar diathermy technique. Post-operatively, the children who had bipolar diathermy tonsillectomy were found to be able to drink and eat significantly earlier than the cold dissection group. There was no measurable difference in analgesia requirements before discharge and the time of discharge between the two methods. Post-operative haemorrhage occurred in two out of 60 (3.4 per cent) and one out of 60 (1.7 per cent children) in the conventional and bipolar diathermy dissection, respectively, but this was not statistically significant.

scholarly journals What Are the Trends in Tonsillectomy Techniques in Wales? A Prospective Observational Study of 19,195 Tonsillectomies over a 10-Year Period

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Hussein Walijee ◽  
Ali Al-Hussaini ◽  
Andrew Harris ◽  
David Owens
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Surgical Instrument ◽  
Bipolar Diathermy ◽  
Intraoperative Bleeding ◽  
Surveillance Programme ◽  
National Guidance ◽  
Secondary Haemorrhage ◽  
The Uk ◽  
Cold Steel Dissection

There are a multitude of techniques to undertake tonsillectomy, with hot techniques such as diathermy and coblation being associated with a higher risk of secondary haemorrhage. The UK National Prospective Tonsillectomy Audit (2004) advocated cold steel dissection and ties to be the gold standard. This prospective observational study investigates the trends in tonsillectomy techniques across Wales in the last decade to establish if surgeons have adhered to this national guidance. Data relating to tonsillectomy were extracted over a 10-year period from 1 January 2003 to 31 December 2012 from the Wales Surgical Instrument Surveillance Programme database. A total of 19,195 patients were included. Time-series analysis using linear regression showed there was an increase in the number of bipolar diathermy tonsillectomies by 84% (Pearson’sr=0.762,p=0.010) and coblation tonsillectomies by 120% (r=0.825,p=0.003). In contrast, there was a fall in the number of cold steel dissection tonsillectomies with ties by 60% (r=-0.939,p<0.001). This observational study suggests that the use of bipolar and coblation techniques for tonsillectomy has increased. This deviation from national guidance may be due to these techniques being faster with less intraoperative bleeding. Further study for the underlying reasons for the increase in these techniques is warranted.

scholarly journals Is there any role of post operative antibiotics in reducing secondary haemorrhage after tonsillectomy

2012 ◽  
Vol 18 (2) ◽  
pp. 166-170
Author(s):  
Mohammad Shah Kamal ◽  
Rubina Farzana ◽  
Ahmed Tariq ◽  
Abu Hena Mohammad Parvez Humayun
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Antibiotic Group ◽  
Group A ◽  
Secondary Haemorrhage ◽  
Group B ◽  
A Prospective Study ◽  
Haemorrhage Rate

Objective: To compare with and without the antibiotic therapy in reducing post-tonsillectomy secondary haemorrhage.Method: A prospective study was conducted at Shaheed Shamsuddin Ahmed Hospital, Sylhet from April 2010 to April 2012. 170 patients who underwent tonsillectomy divided into two groups randomly each consisting of 85 patients. In group A (intervention group) - antibiotic was given post-operatively, while in group B (control group) - no antibiotic was given. Postoperative follow-up was done till the tonsillar fossa healed.Results: Among 170 patients 61.18% were female and 38.82% were male, mean age was 21.58 years. One patient from antibiotic group had secondary haemorrhage (1.18%), while no haemorrhage was observed in non- antibiotic group. Secondary haemorrhage rate was 0.59% in total study population.Conclusion: The study showed that antibiotic did not have any significant role in reducing the post-tonsillectomy secondary haemorrhage DOI: http://dx.doi.org/10.3329/bjo.v18i2.12009 Bangladesh J Otorhinolaryngol 2012; 18(2): 166-170

scholarly journals Comparison of Bipolar Scissors and Bipolar Forceps in Tonsillectomy

2002 ◽  
Vol 81 (10) ◽  
pp. 714-717 ◽  
Author(s):  
Nitesh Patel ◽  
Paul Kirkland ◽  
Pavan Tandon ◽  
Terry Hung ◽  
Jeff Knight
Keyword(s):  
Surgical Technique ◽  
Telephone Survey ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Bipolar Diathermy ◽  
Outpatient Procedure ◽  
Bipolar Scissors ◽  
A Prospective Study ◽  
New Surgical Technique

Bipolar diathermy scissors tonsillectomy is a relatively new surgical technique. We conducted a prospective study of 90 patients to compare this technique with bipolar forceps tonsillectomy. We found that the use of the bipolar scissors required significantly less operating time (mean: 3.03 min less) and allowed patients to resume eating solid food more rapidly (mean: 40.35 min earlier). Bipolar scissors tonsillectomy was safe, and there were no intraoperative complications or primary hemorrhages. A postoperative follow-up telephone survey revealed that patients who underwent scissors tonsillectomy experienced no more morbidity than did the forceps group during the first 2 weeks after surgery. We conclude that bipolar scissors tonsillectomy is a safe and rapid technique that can be used successfully as an outpatient procedure.

scholarly journals Clinicopathological study and management of benign biliary stricture

2019 ◽  
Vol 6 (4) ◽  
pp. 1199
Author(s):  
Sailendra Nath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Clinical Outcome ◽  
Clinical Judgment ◽  
Biliary Stricture ◽  
Surgical Intervention ◽  
Benign Biliary Stricture ◽  
Benign Biliary Strictures ◽  
Life Threatening ◽  
Study Population ◽  
A Prospective Study

Background: A stricture of the biliary tract can be one of the most difficult challenges that a surgeon can face. If unrecognized or managed improperly life threatening complications may develop. The goal of this study is to describe the most appropriate management for benign biliary stricture.Methods: This was a prospective study done on 29 patients diagnosed with benign biliary stricture. Complete biochemical profile, USG-whole abdomen, and other radiological investigations were done to evaluate the detailed etiological condition of the patient. Appropriate surgical intervention was implemented in the patients. Related complications and clinical outcome was observed during the follow up period of 2 years.Results: Mean age of the study population was 45 years (ranging from 22-62 years). Female preponderance was seen in the study. USG of abdomen was done in all the patients (100%). Overall complications were observed in 15 patients.Conclusions: Benign biliary strictures occur more often in women. Complications and clinical outcome depends on the time of diagnosis, matured clinical judgment and appropriate surgical intervention. Hepaticojejunostomy (HJJ) was the common surgical procedure adopted in in 23 patients.

Bipolar diathermy or ligation for haemostasis in tonsillectomy? A prospective study on post-operative pain

1992 ◽  
Vol 106 (1) ◽  
pp. 21-22 ◽  
Author(s):  
A. T. K. Choy ◽  
A. P. Su
Keyword(s):  
Prospective Study ◽  
Controlled Trial ◽  
Blind Study ◽  
Bipolar Diathermy ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Secondary Haemorrhage ◽  
A Prospective Study ◽  
Single Blind

AbstractForty-nine children for tonsillectomy were entered in a prospective controlled single blind study to compare the post-tonsillectomy morbidity of bipolar diathermy as opposed to ligation for haemostasis. We found no significant difference in post-operative discomfort nor reactionary or secondary haemorrhage in the two methods used. This is the first controlled trial where bipolar, rather than unipolar diathermy is used, and compared with ligation in the operation of tonsillectomy

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