ABSTRACT
INTRODUCTION: Tonsillectomy may be performed by several methods. It is continuously being discussed which method is preferable with regard to postoperative haemorrhage, pain, activity and nutrition. MATERIAL AND METHODS: The present study is a prospective non-randomized study of tonsillectomy. It included 198 patients aged 14-40 years who either underwent coblation tonsillectomy or traditional "cold" tonsillectomy after random allocation to different surgeons. A total of 51 patients underwent coblation tonsillectomy and 147 patients underwent traditional tonsillectomy. We tested the hypothesis that there is no difference in postoperative pain experience between the two surgical techniques. The patients were followed for nine days postoperatively. They filled in a questionnaire on postoperative pain score, activity level and food intake. RESULTS: We found no statistically significant difference in pain perception between the two groups and there was no difference in their levels of activity. The intraoperative haemorrhage was significantly reduced in the coblation tonsillectomy group, but there was no difference in postoperative haemorrhage between the two groups. CONCLUSION: The overall results of this study suggest that neither coblation tonsillectomy nor traditional tonsillectomy enjoys an advantage over the other in patients aged 14-40 years. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
Subject(s)
Activities of Daily Living , Eating , Electrosurgery , Pain, Postoperative/etiology , Postoperative Hemorrhage/etiology , Tonsillectomy , Adolescent , Adult , Blood Loss, Surgical/prevention & control , Electrosurgery/adverse effects , Electrosurgery/methods , Electrosurgery/rehabilitation , Female , Humans , Male , Postoperative Period , Practice Patterns, Physicians'/standards , Professional Practice/standards , Random Allocation , Recovery of Function , Surgical Instruments/adverse effects , Tonsillectomy/adverse effects , Tonsillectomy/methods , Tonsillectomy/rehabilitation , Treatment OutcomeABSTRACT
OBJECTIVE: To determine when it is safe for healthy children to return to home, school, and sports after uncomplicated electrosurgical adenoidectomy (EA). DESIGN: (1) A survey of Canadian otolaryngologists (COs) regarding their EA complication rates and their opinions regarding best practice standards for patient care after EA. (2) Informal retrospective analysis of approximately 200 children who have been allowed to resume sports 3 days after uncomplicated EA. RESULTS: (1) Thirteen COs responded to the survey. The total estimated EA cases performed were 8617 over 10 years. Four patients were known to have bled mildly; none required reoperation. Eleven of 13 COs supported discharge home 2 hours after uncomplicated EA if other standard discharge criteria were met. Seven of 13 COs supported a return to school the next day if the child had returned to his or her usual state of health; however, 2 COs suggested 7 to 10 days at home. Four of 13 COs supported a return to sports 3 days after uncomplicated EA. (2) None of the 200 children who had been allowed to resume sports 3 days after uncomplicated EA have had any known bleeding. At least 10 toddlers have actually engaged in unplanned strenuous exercise within 4 to 6 hours of EA without adverse effect. CONCLUSIONS: Considerable variation exists in Canada in terms of current practice standards regarding return to home, school, and sports after uncomplicated EA. Survey data suggest that, after uncomplicated EA, it is safe for healthy children to return home after 2 hours and to school the next day. Preliminary data suggest that it may be safe for children to resume sports 3 days after uncomplicated EA; however, ideally, this should be studied prospectively, on a large scale.
