ABSTRACT
Abstract Introduction Tonsillectomy is one of the most common surgeries in the head and neck worldwide. This operation is carried out by different methods, the most frequent of which are the cold dissection and bipolar electrocautery techniques. Objective This study was conducted to assess and compare postoperative morbidity between cold dissection and bipolar electrocautery. Methods This prospective randomized clinical trial was performed on 534 patients who underwent tonsillectomy in Vali-e-Asr Hospital of Birjand, east of Iran from October, 2013 to October, 2015. The patients were systematically selected for cold dissection technique or bipolar electrocautery technique groups. Time of surgery, amount of intraoperative blood loss, postoperative hemorrhage, the intensity of local pain 4 and 24 hours after operation and nausea and/or vomiting were recorded and compared in the two groups to decide which technique is better. The data were analyzed in SPSS software (ver-22). The p-value less than 0.5 was considered significant. Results In this study, 51.7% of the cold dissection technique patients and 50.6% of the bipolar electrocautery technique participants were male. Compared to the cold dissection technique, the average intraoperative blood loss was significantly lower (p < 0.001) in the bipolar electrocautery technique group, while the intensity of local pain 4 and 24 hours after the operation was significantly higher (p < 0.001). Other variables showed no significant differences between the two groups. Conclusion Based on the findings of the present investigation, the bipolar electrocautery technique is suggested for tonsillectomy in children, while the cold dissection technique is preferred for adult patients.
Resumo Introdução A tonsilectomia é uma das cirurgias mais comuns de cabeça e pescoço em todo o mundo. Essa cirurgia é feita por diferentes métodos, os mais frequentes são a dissecção a frio e por eletrocauterização bipolar. Objetivo Este estudo foi feito para avaliar e comparar a morbidade pós-operatória na dissecção a frio e eletrocauterização bipolar. Método Este ensaio clínico prospectivo e randomizado foi feito em 534 pacientes submetidos a tonsilectomia no Vali-e-Asr Hospital de Birjand, no leste do Irã, de outubro de 2013 a outubro de 2015. Os pacientes foram selecionados de forma sistemática para o grupo submetido à técnica de dissecção a frio ou para o grupo com uso da técnica de eletrocauterização bipolar. Para a avaliação acerca da melhor técnica, os seguintes parâmetros foram registrados e comparados entre os dois grupos: tempo de cirurgia, quantidade de perda sanguínea intraoperatória, hemorragia pós-operatória, intensidade da dor local 4 e 24 horas após a cirurgia e ocorrência de náuseas e/ou vômitos. Os dados foram analisados no software SPSS (versão 22). O valor de p inferior a 0,5 foi considerado significante. Resultados Neste estudo, 51,7% dos participantes do grupo técnica de dissecção a frio e 50,6% do grupo técnica de eletrocauterização bipolar eram do sexo masculino. No grupo operado pela técnica de eletrocauterização bipolar a média de perda sanguínea intraoperatória foi significantemente menor (p < 0,001) em comparação à técnica de dissecção a frio, enquanto a intensidade da dor local 4 e 24 horas após a cirurgia foi significativamente maior (p < 0,001). As outras variáveis não apresentaram diferenças significantes entre os dois grupos. Conclusão Com base nos achados da presente investigação, para a tonsilectomia em crianças sugere-se o uso da técnica de eletrocauterização bipolar, enquanto a técnica de dissecção a frio é recomendada para pacientes adultos.
Subject(s)
Humans , Male , Tonsillectomy , Pain, Postoperative , Prospective Studies , Postoperative Hemorrhage , Electrocoagulation , IranABSTRACT
Objective To assess the efficacy and safety of transurethral bipolar electrocautery resection of the superficial bladder tumor(Bipolar-TURBt).Methods 26 patients with superficial transitional cell carcinoma(13 with tumors appear at the lateral wall) were treated by bipolar TURBt. All patients were followed-up in 1～6 months postoperatively.Results The duration of the procedure was(19?10) min(8～35 min) with little bleeding. Bladder perforation was occurred in no case. No TUR-syndrom was found. The adductor reflex was not found even in the 13 cases with tumor located at the lateral wall.Conclusion Transurethral bipolar electrocautery resection of the superficial bladder tumor is effective and safe.
ABSTRACT
Objective To assess the efficacy and safety of transurethral resection of the prostate(PKRP) and bladder tumor(PKRBT) with plasmakinetic energy. Methods 300 patients(mean age of 71.6 years;range from 52 to 91) with symptomatic BPH without suspected cancer (confirmed by IPSS,urinary flow rate,ultrasonographic estimate and PSA tests) were treated by PKRP. 37 patients with superficial transitional cell carcinoma (17 with tumors appearing at the lateral wall) were treated by PKRBT.All patients were followed up for 1～6 months postoperatively. Results For PKRP,the duration of the procedure was (48?31) min(range 13 to 98 min).No case need blood transfusion during the operation.No transurethral resection syndrom occurred.The mean catheterization time was 2 days (1 to 4 days). The peak flow rate increased from (5.2?3.9) to (19.2?4.1),(21.8?4.6),(22.3?5.7)ml/s at 1,3 and 6 months respectively. The IPSS decreased from 24.7 to 5.7, 5.4,5.0 and the QOL decreased from 5.3 to 1.7,1.8,1.2 at 1,3 and 6 months respectively.For PKRBT,the duration of the procedure was (24?13) min(range 5 to 39 min) with little bleeding.The adductor reflex was found in 5 of the 17 cases with tumor located at the lateral wall. Conclusions It is suggested that transurethral bipolar plasmakinetic resection of the prostate and bladder tumor is effective and safe. This pilot series permits a comparative study with conventional TUR system.