A Comparative Study of Coblation versus Dissection Tonsillectomy

Objectives: To compare the efficacy of coblation tonsillectomy and dissection tonsillectomy regarding the duration of surgery, amount of intraoperative bleeding, postoperative pain, recovery time and complications. Methods: 50 patients aged 5-30 years with chronic tonsillitis who underwent tonsillectomy operation were randomly divided into two groups. One group underwent coblation tonsillectomy while other group with dissection tonsillectomy. Chronic tonsillitis patients with adenoid hypertrophy and Otitis media with effusion were excluded by diagnostic nasal endoscopy, imaging and audiometry. All patient were examined regularly after surgery for 10 days to assess the postoperative morbidity and efficacy of both coblation and dissection methods. Duration of surgery, amount of intraoperative bleeding, recovery time, postoperative pain& requirement of analgesics, time required to regain normal diet & activityand complication were assessed. Result: Comparing the coblation tonsillectomy to cold dissection group the mean duration of surgery was 9.7 versus 18.4 minutes, the amount of intra operative bleeding 10.62 versus 28.72 milliliter. The difference on the postoperative pain scale, requirement of analgesics, condition of the tonsillar fossa, time required to regain normal diet & activity between two groups were statistically significant. Conclusion: In our study patient underwent coblation tonsillectomy providing a near bloodless field, minimum operating time, less postoperative pain, quicker return to normal diet, normal activity and less use of analgesics than patients underwent dissection tonsillectomy. Postoperative morbidity and complications were lower as compared to conventional cold dissection technique. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 121-127

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Coblation tonsillectomy versus coblation tonsillectomy with ties in adults

Journal of International Medical Research ◽

10.1177/0300060519867822 ◽

2019 ◽

Vol 47 (10) ◽

pp. 4734-4742 ◽

Cited By ~ 1

Author(s):

Xuanchen Zhou ◽

Anting Xu ◽

Xiaoyue Zhen ◽

Kun Gao ◽

Zhaoyang Cui ◽

...

Keyword(s):

Postoperative Pain ◽

Food Intake ◽

Postoperative Bleeding ◽

Postoperative Hemorrhage ◽

Normal Diet ◽

Intraoperative Bleeding ◽

Normal Food

Objective This study was performed to compare the intraoperative and postoperative courses of coblation tonsillectomy and coblation tonsillectomy with ties in adults. Methods All patients who underwent tonsillectomy from July 2012 to September 2016 were retrospectively reviewed. Intraoperative and postoperative bleeding, pain, and return to normal food intake were compared between patients who underwent coblation tonsillectomy and those who underwent coblation tonsillectomy with ties. Results Of 515 patients, 300 (58.3%) underwent coblation tonsillectomy and 215 (41.7%) underwent coblation tonsillectomy with ties. Twenty-five (4.9%) patients developed postoperative hemorrhage, 22 (88.0%) of whom had undergone coblation tonsillectomy and 3 (12.0%) of whom had undergone coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy reported less pain than those who underwent coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy with ties resumed a normal diet significantly later than those who underwent coblation tonsillectomy (10.0 ± 3.2 vs. 8.2 ± 1.9 days, respectively). Conclusion Coblation tonsillectomy is associated with less intraoperative bleeding, a shorter surgery time, less postoperative pain, and fewer days to recovery of a normal diet than is coblation tonsillectomy with ties. However, coblation tonsillectomy with ties is associated with remarkably reduced postoperative hemorrhage.

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Comparison between dissection method and coblation technique in tonsillectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194934 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1607

Author(s):

Shreyas S. Joshi ◽

Vinayak Raikar

Keyword(s):

Chronic Tonsillitis ◽

P Value ◽

Safe Procedure ◽

Duration Of Surgery ◽

The Mean ◽

Operative Recovery ◽

Dissection Technique ◽

Cold Dissection ◽

Dissection Method

Background: The objective of the present study was to compare the dissection method and coblation technique in tonsillectomy in patients of chronic tonsillitis.Methods: This is prospective study in which 40 patients of chronic tonsillitis in age group of 5-12 years were selected in this study. Patients were blinded with regards to technique used to remove tonsils. 20 patients underwent tonsillectomy by cold dissection method and 20 with coblation method. In both techniques, duration of surgery and amount of blood loss were recorded and compared. Results: In our study, the mean operative time from giving incision to achieving complete haemostasis for dissection method was 42.9 minutes and that for coblation technique was 34 minutes. The amount of blood lost on an average by dissection method was 51.8 ml, and by coblation technique was 22.3 ml. This difference was found to be statistically significant. Pain was evaluated by visual analogue scale. The data recorded from two groups was put to statistical analysis and ‘p’ value was calculated using independent t-test. The mean pain score for coblation technique averaged over 10 days was 2.72 and was 4.84 for dissection technique.Conclusions: We can conclude that coblation tonsillectomy is an easy to learn safe procedure with significant advantages in terms improving the quality of post-operative recovery compared to that following the cold dissection technique. But cost effectiveness of dissection method outweighs benefits of coblation at present in Indian scenario.

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Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190492 ◽

2019 ◽

Vol 5 (2) ◽

pp. 306

Author(s):

Shifa Vyas ◽

Pritosh Sharma ◽

Nitin Sharma ◽

Abhijit Makwana ◽

V. P. Goyal

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Randomized Study ◽

Postoperative Bleeding ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Intraoperative Bleeding ◽

Time Required ◽

Pain Patients ◽

Better Than

Background: The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.Methods: A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared. Results: Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.Conclusions: Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164814 ◽

2016 ◽

Vol 3 (1) ◽

pp. 122 ◽

Cited By ~ 1

Author(s):

Nithya V. ◽

Angshuman Dutta ◽

Sabarigirish K.

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Postoperative Period ◽

P Value ◽

Intraoperative Blood Loss ◽

Pain Scores ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean ◽

Cold Dissection

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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Coblation cryptolysis for treatment of tonsillar stones: a randomized clinical study

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00106-9 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Osama A. Elsayad ◽

Mohammed S. Hussein

Keyword(s):

Operative Time ◽

Randomized Study ◽

Normal Diet ◽

Bipolar Diathermy ◽

Intraoperative Bleeding ◽

Surgical Interventions ◽

Operative Outcomes ◽

Randomized Clinical Study ◽

Dissection Techniques ◽

Cold Dissection

Abstract Background Tonsillectomy is usually indicated in patients with tonsillar stones. It is thought coblation cryptolysis avoids the hazards related to monopolar bipolar diathermy and the regular cold surgical technique. This study compared the peri-operative outcomes in patients with tonsillar stones submitted to coblation cryptolysis, monopolar bipolar dissection, and cold dissection techniques. This randomized study included 105 patients with tonsillar stones. The included patients comprised three groups: GI (n = 35) was subjected to cold dissection, GII (n = 35) was subjected to monopolar bipolar diathermy tonsillectomy, and GIII (n = 35) was subjected to coblation cryptolysis. Outcome parameters included operative time, intraoperative bleeding, consumption of postoperative analgesia, and time to normal food intake. Results GIII patients experienced significantly shorter operative time, less intraoperative bleeding, less consumption of postoperative analgesics, and less time to normal diet when compared with the other two groups. Conclusion Coblation cryptolysis is a safe and effective technique in the management of tonsillar stones. It appears to be superior to other surgical interventions.

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Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

10.22541/au.163252266.66248446/v1 ◽

2021 ◽

Author(s):

Xinqi Hu ◽

Jiaying Li ◽

Xidong Cui ◽

Guangbin Sun

Keyword(s):

Postoperative Pain ◽

Operative Time ◽

Harmonic Scalpel ◽

Postoperative Bleeding ◽

Growth Time ◽

Recurrent Tonsillitis ◽

Intraoperative Bleeding ◽

Significant Difference ◽

Double Blinded ◽

Cold Dissection

Objectives: To compare the safety and effectiveness of tonsillectomy with three different techniques. Design: A double-blinded randomized prospective clinical trial Setting and Participants: Totally120 patients with recurrent tonsillitis between April 2018 and April 2020 were included. Main Outcome Measures: Operative time, intra and post operative bleeding loss, pseudomembrane growth time, pseudomembrane shedding time, postoperative pain, and necrosis depth of specimens were compared of harmonic scalpel(HS), coblation and cold dissection(CD) tonsillectomy. Results: The operative time and intraoperative bleeding loss was significantly less in HS and coblation group than CD group(p < 0.05). Pseudomembrane growth time and pseudomembrane shedding time were significantly longer in the HS group compared with the other groups(p < 0.05). The postoperative pain levels were significantly higher on the first postoperative day in CD group(p < 0.05), and significantly lower on the third and seventh postoperative day in coblation group(p < 0.05). There was no significant difference among three techniques in terms of postoperative bleeding loss(p > 0.05). The deepest necrosis depth in specimen was found in HS group(p > 0.05), while in CD group, only edema was observed without necrosis. Conclusion: To compared with HS and CD, coblation is a faster, safer and more painless technique for tonsillectomy in adult.

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Pancreas-Preserving Total Duodenectomy: A Systematic Review

Digestive Surgery ◽

10.1159/000515718 ◽

2021 ◽

pp. 1-12

Author(s):

Miguel Cantalejo-Díaz ◽

José Manuel Ramia-Ángel ◽

Ana Palomares-Cano ◽

Mario Serradilla-Martín

Keyword(s):

Systematic Review ◽

Postoperative Morbidity ◽

Operating Time ◽

Pancreatic Head ◽

Cochrane Library ◽

Morbidity Rate ◽

Intraoperative Bleeding ◽

Risks And Benefits ◽

Duodenal Lesions ◽

The Mean

Background: The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. Summary: A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo <IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was >97.8%. Key Messages: PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.

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Different characteristics of infants diagnosed with congenital choledochal malformation prenatally or postnatally

Scientific Reports ◽

10.1038/s41598-020-79569-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wei Chen ◽

Jia Geng ◽

Ya-lan Tan ◽

Lian Zhao ◽

Hui-hui Jia ◽

...

Keyword(s):

Histopathological Examination ◽

Fibrous Tissue ◽

Operation Time ◽

Normal Diet ◽

Treatment Regimens ◽

Total Length ◽

Time Required ◽

Different Characteristics ◽

Length Of Hospitalization ◽

Choledochal Malformation

AbstractThe general condition, clinical and pathological characteristics, and treatment regimens of patients prenatally and postnatally diagnosed with congenital choledochal malformation (CM) were analyzed in order to investigate the clinical significance of early diagnosis, treatment, and intervention in CM. We retrospectively analyzed 33 children who were admitted to the Children’s Hospital of Soochow University between 1 March 2010 and 31 May 2019, and their diagnosis of CM was confirmed by radiological, surgical and pathological findings. All the patients were under 36 months of age. The patients were divided into prenatally diagnosed and postnatally diagnosed groups. There were 16 and 17 CM patients in the prenatally and postnatally diagnosed groups, respectively, with a preponderance of females in both groups. Compared with the prenatally diagnosed group, the postnatally diagnosed group had a higher incidence of abdominal pain and vomiting (p < 0.05) and higher AST, GGT, and TB levels (p < 0.05). Although postoperative histopathological examination showed inflammation in both groups, congestion in the cyst walls and fibrous tissue hyperplasia were more significant in the postnatally diagnosed group (p < 0.05). In addition, operation time, length of time required to resume a normal diet after surgery, and total length of hospitalization differed between the 2 groups (p < 0.05), with the prenatally diagnosed group having a relatively longer operation time and taking longer to resume a normal diet after surgery. However, the total length of hospitalization in the prenatally diagnosed group was shorter than that in the postnatally diagnosed group. Compared with prenatally diagnosed CM patients, more symptoms, greater severity of symptoms, and more time to recovery after surgery were observed in postnatally diagnosed CM patients.

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Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

Journal of Neurosurgery ◽

10.3171/2015.10.jns151516 ◽

2016 ◽

Vol 125 (6) ◽

pp. 1513-1522 ◽

Cited By ~ 22

Author(s):

Nir Shimony ◽

Uri Amit ◽

Bella Minz ◽

Rachel Grossman ◽

Marc A. Dany ◽

...

Keyword(s):

Postoperative Pain ◽

Sleep Quality ◽

Rating Scale ◽

Preoperative Anxiety ◽

Controlled Study ◽

Double Blind ◽

Analgesic Consumption ◽

Pain Scores ◽

Neurosurgical Patients ◽

Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

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Tonsillectomia versus tonsillotomia

Orvosi Hetilap ◽

10.1556/650.2020.31849 ◽

2020 ◽

Vol 161 (45) ◽

pp. 1920-1926

Author(s):

Eszter Erdélyi ◽

Gréta Csorba ◽

Beáta Kiss-Fekete ◽

Gabriella Fekete-Szabó ◽

Balázs Sztanó ◽

...

Keyword(s):

Wound Healing ◽

Postoperative Pain ◽

Recovery Time ◽

Postoperative Bleeding ◽

Bleeding Rate ◽

Significant Difference ◽

Group A ◽

Cold Knife ◽

Active Return ◽

Socioeconomic Benefits

Összefoglaló. Bevezetés és célkitűzés: A szerzők a posztoperatív fájdalom és a sebgyógyulás tekintetében prospektív vizsgálattal hasonlították össze gyermekeken (67 fő, 1–12 év) a hagyományos hidegeszközzel történő extracapsularis tonsillectomiát (23 fő) a microdebriderrel (23 fő) és a coblatorral (21 fő) végzett intracapsularis tonsillotomiával. Módszer: A vizsgálatok a betegek által kitöltött kérdőívek, valamint prospektív klinikai adatgyűjtés alapján történtek. Eredmények: Az intracapsularis tonsillotomia gyógyulási idejét 50%-kal rövidebbnek találtuk, és az első 13 napban szignifikánsan kevesebb fájdalommal és fájdalomcsillapító igénnyel járt, mint az extracapsularis tonsillectomia eseteiben. A tonsillotomiás csoporton belül egyedül a posztoperatív első napi fájdalom tekintetében észleltünk szignifikáns különbséget a két különböző módszer között a coblator javára (p<0,05). A vizsgálatokat retrospektív áttekintéssel is kiegészítettük, 4 évi gyermek- (1–15 éves) tonsillaműtéten átesett beteganyagunk (1487 fő) eredményeinek feldolgozásával. Tonsillectomia (1253 fő) után 7,7%-os utóvérzési arányt észleltünk, műtéti vérzéscsillapításra 1,3%-ban volt szükség. Tonsillotomia esetén (234 fő) 0,43%-os utóvérzési arányt regisztráltunk. Ebben a csoportban vérzés miatt nem, de 2 esetben ismételt obstrukciót okozó hypertrophia, 1 esetben góctünetek miatt reoperációt végeztünk (1,28%). Következtetés: Eredményeiket a szerzők a nemzetközi ajánlások tükrében elemezték. Az intracapsularis tonsillotomia kisebb fájdalommal, kisebb vérzéssel és kisebb megterheléssel jár. A közösségbe való aktív visszatérés akár egy hét után lehetséges a tonsillectomiára jellemző 3 héttel szemben, mindez jelentős szocioökonómiai előnyökkel járhat. Orv Hetil. 2020; 161(45): 1920–1926. Summary. Introduction and objective: Examining operated children in this prostective study inditerscompared (67 pts, 1–12 yrs) the extracapsular tonsillectomy with conventional cold-knife (23 pts) to extracapsular tonsillotomy with microdebrider (23 pts) and coblator (21 pts) for postoperative pain and wound-healing disorders. Method: The study was based on patient-completed questionnaires as well as prospective clinical data collection. Results: The recovery time of intracapsular tonsillotomy was found less than 50%, with less pain than in the cases of extracapsular tonsillectomy. Postoperative pain was significantly less in the tonsillototomy group than the tonsillectomy group. Within the tonsillotomy group, a significant difference was observed between the two different methods in favor of the coblator for only the postoperative first-day pain. The studies were supplemented with a retrospective review by processing the 4 yrs results of their pediatric (1–15-yrs) patients who underwent tonsillectomy (1487 pts). After tonsillectomy (1253 pts), a postoperative bleeding rate of 7.7% was observed, and surgical hemostasis was required in 1.3%. In the case of tonsillotomy (234 pts), a postoperative bleeding rate of 0.43% was recorded. In this group, reoperation was not performed due to bleeding, whereas it was neccesary in 2 cases due to hypertrophy causing repeated obstruction, in 1 case due by virtue of focal symptomes (1.28%). Conclusion: Our results were analyzed on the basis of international recommendations. Intracapsular tonsillotomy is associated with less pain, less bleeding, and less strain. Active return to the community is possible after up to a week compared to the 3 weeks typical of tonsillectomy, all of which can have significant socioeconomic benefits. Orv Hetil. 2020; 161(45): 1920–1926.

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