Résumé
Abstract Introduction Tonsillectomy is among the most common otolaryngological surgeries. Objective To evaluate and compare three tonsillectomy techniques: cold steel dissection (CSD), monopolar electrocautery (MEC), and coblation. Methods The present study retrospectively reviewed the medical records of patients who underwent tonsillectomy between January 2014 and January 2016. Postoperative visual analog scale (VAS) pain scores, analgesic use, surgical duration, time to return to normal activity, and postoperative bleeding status were noted. Results The CSD group had less analgesic use and shorter return to normal activity than the MEC group (p =0.037 and p < 0.001, respectively). The coblation group had lower VAS pain scores than the MEC group only at 1 hour to 4 hours postsurgery (p <0.016). The postoperative bleeding rate was similar in all groups (p = 0.096). Conclusion Cold steel dissection tonsillectomy is associated with less postoperative pain and shorter recovery than MEC. Coblation is better than MEC in terms of postoperative pain at 1 hour to 4 hours only, whereas CSD is associated with less postoperative pain than coblation at 2 days to 7 days.
Résumé
Background: Laparoscopic appendectomy has gradually become widespread especially in the last decade. Although laparoscopic techniques are similar, different instruments, such as endoscopic stapler, endoscopic clip, monopolar hook cautery, harmonic scalpel, and vessel sealing instrument, can be used in appendiceal mesentery dissection 1, 2. BVS is an effective and safe system to be used at the dissection of appendiceal mesentery and haemostasis and is definitely effective in decreasing the operation period. Objectives: The main objective of the present study was to studyretrospectively, the effects of using monopolar cautery and vessel sealing system on the operation period in the appendix mesentery dissection. Methods: Hundred patients, operated laparoscopically for acute appendicitis in between June 2010 and June 2011, are evaluated retrospectively. Monopolar cautery was used in 50 patients and bipolar vessel sealer was used in 50 patients. No intraoperative or postoperative complication was seen in any of the patients. None of the patients required conversion to open surgery due to dissection problems of the appendiceal mesentery. Results and Interpretation: The mean duration of operation was 51.08 min in the monopolar cautery group whereas 36.68 minutes in the bipolar vessel sealing system group. Conclusion: Bipolar vessel sealeris safer and time saving as compared toMonopolar cauteryin laparoscopic appendectomy.