scholarly journals Comparison of Ultrasonic Device Versus Bipolar Diathermy Tonsillectomy in Children

2019 ◽  
Vol 17 (01) ◽  
pp. 71-75
Author(s):  
Mukesh Kumar Sah ◽  
Yogesh Neupane ◽  
Rajendra Prasad Guragain
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Analog Scale ◽  
Intraoperative Bleeding ◽  
Ultrasonic Device ◽  
Post Operative Pain ◽  
The Mean ◽  
Group Post

Background: Intraoperative bleeding and postoperative pain are two commonest concerns for both patient and surgeon in tonsillectomy. This study was aimed to compare intraoperative blood loss and early postoperative pain between ultrasonic device and bipolar diathermy tonsillectomy in children.Methods: Prospective, interventional, single blinded, comparative study was carried out from September 2016 to September 2017 including children up to age 15 years who underwent tonsillectomy either by bipolar diathermy or ultrasonic device. Intraoperative blood loss was recorded using standard sized gauge technique. Post-tonsillectomy pain on first five postoperative days (early postoperative pain) was assessed using Visual analog scale for children older than 5 years and FLACC score for children up to 5 years respectively.Means were compared.Results: 38 children (76 tonsils) were included in the study out of which 31 were boys (62 tonsils) and 7 were girls (14 tonsils). The mean intraoperative blood loss in ultrasonic dissection group was 13.94 ml and 13.91 ml in bipolar diathermy group. This difference was not statistically significant (p=0.974). Post-operative pain on 1st, 2nd, 3rd and 4th days were significantly less (p<0.05) in ultrasonic device group compared to bipolar diathermy group. Post-operative pain was less also on 5th post-operative day in ultrasonic device but was not statistically significant (p=0.172).Conclusions: Tonsillectomy in children using ultrasonic device did not differ from bipolar diathermy tonsillectomy in respect to intraoperative blood loss. However, early postoperative pain was significantly lower in ultrasonic device group.Keywords: Bipolar diathermy; tonsillectomy; ultrasonic device.

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

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.

scholarly journals Intraoperative Blood Loss and Postoperative Pain in the Sagittal Split Ramus Osteotomy and Intraoral Vertical Ramus Osteotomy: A Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kun-Tsung Lee ◽  
Shiu-Shiung Lin ◽  
Kun-Jung Hsu ◽  
Chi-Yu Tsai ◽  
Yi-Hao Lee ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Lower Amount ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Sagittal Split Ramus Osteotomy ◽  
Intraoral Vertical Ramus Osteotomy ◽  
Vas Scores ◽  
The Mean ◽  
Vertical Ramus Osteotomy

Purpose. The purpose of the present study was to review the literature regarding the blood loss and postoperative pain in the isolated sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). Materials and Methods. Investigating the intraoperative blood loss and postoperative pain, articles were selected from 1970 to 2021 in the English published databases (PubMed, Web of Science, and Cochrane Library). Article retrieval and selection were performed by two authors, and they independently evaluated them based on the eligibility criteria. The articles meeting the search criteria had especially at least 30 patients. Results. In the review of intraoperative blood loss, a total of 139 articles were retrieved and restricted to 6 articles (SSRO: 4; IVRO: 2). In the review of postoperative pain, a total of 174 articles were retrieved and restricted to 4 articles (SSRO: 3; IVRO: 1). The mean blood loss of SSRO and IVRO was ranged from 55 to 167 mL and 82 to 104 mL, respectively. The mean visual analog scale (VAS) scores of the first postoperative day were 2 to 5.3 in SSRO and 2.93 to 3.13 in IVRO. The mean VAS scores of the second postoperative day were 1 to 3 in SSRO and 1.1 to 1.8 in IVRO. Conclusion. Compared to traditional SSRO, IVRO had a significantly lower amount of blood loss. However, the blood transfusion is not necessary in a single-jaw operation (SSRO or IVRO). Postoperative pain was similar between SSRO and IVRO.

Reduced Postoperative Pain after Inguinal Hernia Repair with Absorbable String in Children

2014 ◽  
Vol 618 ◽  
pp. 401-404
Author(s):  
Chuan Zhang ◽  
Chun Yu Dong ◽  
Xue Song Zhao ◽  
Ji Xue Zhao ◽  
Dan Dang ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Blood Loss ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
High Ligation ◽  
Absorbable Suture ◽  
Intraoperative Blood Loss ◽  
Hernia Sac ◽  
The Mean

Object: To investigate effects of the high ligation of hernia sac with absorbable string for children with indirect inguinal hernia. Method: A retrospective analysis of 92 patients with inguinal hernia who underwent the high ligation of hernia sac was conducted in the present study, in which 20 cases underwent the high ligation of hernia sac with absorbable string while 72 cases treated with the high ligation of hernia sac with non-absorbable suture. The mean operation time, mean intraoperative blood loss and average postoperative hospital stay and postoperative pain rating were analyzed. Results: Though no statistical difference existed in the mean operation time, mean intraoperative blood loss, average postoperative hospital stay between the two groups (P>0.05). However, the postoperative pain in the high ligation of hernia sac with absorbable string group was significantly lower than that of the non-absorbable group. Conclusion: Compared with that of the high ligation of hernia sac with non-absorbable string, there is lower grade postoperative pain in the high ligation with absorbable suture.

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

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

<p class="abstract"><strong>Background:</strong> The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

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

2016 ◽  
Vol 3 (1) ◽  
pp. 122 ◽  
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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> 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 &lt;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<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> 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<span lang="EN-IN">.</span></p>

scholarly journals Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Emanuele Ferri ◽  
Enrico Armato ◽  
Giacomo Spinato ◽  
Marcello Lunghi ◽  
Giancarlo Tirelli ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Neck Dissection ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Classic Technique

Purpose.The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy).Materials and methods.Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications.Results.The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications.Conclusion.The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

2021 ◽  
Author(s):  
Hai Thanh Phan
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Operative Time ◽  
Distal Gastrectomy ◽  
Three Dimensional ◽  
Oncologic Outcome ◽  
Intraoperative Blood Loss ◽  
3D Laparoscopy ◽  
Distal Gastric Cancer ◽  
The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

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