DOI: https://doi.org/10.30841/2307-5112.1-2.2020.204601

Surgical Treatment of Chronic Tonsillitis

І. А. Косаківська

Abstract


The use of diathermy or coblation for both tissue dissection and hemostasis reduced primary bleeding but increased the risk of secondary bleeding compared with traditional tonsillectomy.

The objective: was to increase the effectiveness of surgical treatment of children with chronic tonsillitis.

Materials and methods. We observed 75 children with chronic tonsillitis between the ages of 6 and 17 under our observation. There were52 in the main group,23 in the comparison group. During tonsillectomy, bipolar instruments and the mode of operation of the high frequency current generator «manual welding» («overlap») with a current frequency of 66 kHz or 440 kHz were used in the main group.

Results. With tonsillectomy using high-frequency current, intraoperative blood loss was 6,0±0,440 ml, while during tonsillectomy by the traditional method, intraoperative blood loss was 32,48±1,781 ml (p<0,001) (blood loss when using high-frequency current was 5,4 times lower). The time of tonsillectomy is reduced by 2,1 times. The manifestations of local tissue reaction after tonsillectomy with and without the use of electrothermal adhesion are not significantly different, except for sore throat.

Conclusions. The use of high-frequency bipolar welding of biological tissues with the use of developed bipolar power tools for tonsillectomy significantly improves the quality of operations, namely, blood loss during tonsillectomy is reduced by 5,3 times (p<0,001), the duration of surgery is reduced by 2,1 times. Secondary bleeding was not observed in patients using the proposed procedure. The manifestations of local tissue reaction after tonsillectomy with and without the use of electrothermal adhesion are not significantly different.

Keywords


chronic tonsillitis; tonsillectomy; electrothermal adhesion; children

References


Van Den Akker EH, Hoes AW, Burton MJ, Schilder AG. Large international differences in (adeno) tonsillectomy rates. Clin Otolaryngol Allied Sci. 2004 Apr;29(2):161–164.

Baugh RF, Archer SM, Mitchell RBet al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 2011; 144:S1-30.

Royal College of Surgeons of England. National prospective tonsillectomy audit: final report of an audit carried out in England and Northern Ireland between July 2003 and September 2004. May 2005. http://www.entuk.org/members/audits/tonsil/ Tonsillectomy audit report pdf. Accessed February 3, 2010.

Mowatt G, Cook JA, Fraser C, et al. Systematic review of the safety of electrosurgery for tonsillectomy. Clin Otolaryngol. 2006;31:95-102.

Soöderman, Hessén A-C, Odhagen E et al. Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis. An analysis of 15734 patients in the National Tonsil Surgery Register in Sweden. Clin. Otolaryngol. 2015, 40, 248–254.

Burton MJ, Doree C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev. 2007;(3): CD004619.

Neumann C, Street I, Lowe D, et al. Harmonic scalpel tonsillectomy: a systematic review of evidence for postoperative hemorrhage. Otolaryngol Head Neck Surg. 2007;137:378-384.

Sarny S, Ossimitz G, Habermann W, Stammberger H. «Die Österreichische Tonsillenstudie 2010» – Teil 1: Statistischer Überblick. Laryngo-rhino-otologie 2012; 91:16-21.

Per Attner, Claes Hemlin, Anne-Charlotte Hessen Söderman. Ligasure versus diathermy scissors tonsillectomy: A controlled randomized study // Acta Otolaryngologica, 2010; 130: 1180–1184

Косаковський АЛ, Косаківська ІА, Семенов РГ, Семенов ВР (2011). Патент України на винахід № 96640. МПК А61В17/02 (2006.01), А61В17/24 (2006.01), А61В17/3211 (2006.01), А61В18/12 (2006.01). Распатор Косаківської-Семенова. Заявлено 13.02.2010; Опубл. 25.11.2011 р. Бюл. № 22.

Косаковський АЛ, Семенов РГ, Косаківська ІА, Семенов ВР (2010). Патент України на винахід № 92559. МПК (2009) А61В17/00. Електроскальпель. Заявлено 01.07.2009. Опубл. 10.11.2010. Бюл. 21.




Copyright (c) 2020 І. А. Косаківська

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

ISSN 2412-8708 (Online), ISSN 2307-5112 (Print)

Flag Counter

ISSN (print): 2307-5112.