Immunological Repercussion of Adenotonsillectomy

Autor: Raimar Weber, Tiago Vasconcelos Souza, Shirley Shizue Nagata Pignatari, Fábio Pires Santos, Aldo Cassol Stamm
Rok vydání: 2010
Předmět:
Zdroj: Otolaryngology–Head and Neck Surgery. 143
ISSN: 1097-6817
0194-5998
DOI: 10.1016/j.otohns.2010.06.543
Popis: guillotine versus dissection tonsillectomy in children aged between 3 and 11 years. Both techniques (side randomized) were performed on the same patient by the same surgeon between July 2007 and August 2009. Operative time was measured in minutes from the insertion of the mouth gag to its removal for each technique. Blood loss was measured by wet weight of tonsil swabs. Pain was measured using a 6-point visual analogue score at five post-operative time points. Post-operative hemorrhage was recorded and bleeding side noted. Wilcoxon tests were used to investigate differences in operative time and blood loss, and area under the curve (AUC) was calculated for the pain scores over time. A McNemar Chi-square test was used to investigate the proportion of complications by each technique. RESULTS: Guillotine tonsillectomy resulted in significantly lower operative time (P 0.001), intra-operative blood loss (P 0.001) and pain score at all time points (P 0.001) compared with dissection tonsillectomy. All three secondary hemorrhages recorded were from the dissection side (P 0.05). CONCLUSION: Guillotine tonsillectomy has fallen out of favor due to perceived intraand post-operative complications. This study demonstrates a superior safety profile of Guillotine tonsillectomy as compared to conventional cold steel dissection. We recommend current and future ENT surgeons should be exposed to this useful and easy to master technique as an additional option for tonsillectomy.
Databáze: OpenAIRE
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