Karatzanis Alexandros, Bourolias Constantinos, Prokopakis Emmanuel, Panagiotaki Irene, Velegrakis George
Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece.
Am J Otolaryngol. 2008 Jul-Aug;29(4):238-41. doi: 10.1016/j.amjoto.2007.08.004. Epub 2008 Apr 18.
The objective of the study was to compare and assess parameters related to thermal welding tonsillectomy (TWT) vs ligasure tonsillectomy (LT).
This was a prospective randomized study.
A prospective study was conducted on 143 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy or any procedure together with tonsillectomy and patients with peritonsillar abscess history or bleeding disorders were excluded. Patients were randomly assigned to either the TWT or LT group. Intraoperative bleeding, operative time, postoperative pain using a visual analogue scale, and complication rates were evaluated.
There was no measurable intraoperative bleeding in any group. No significant difference regarding mean operative time was noted. Mean postoperative pain score was significantly lower in the TWT group. Late postoperative hemorrhage was noted in 1 subject of the TWT and 2 subjects of the LT group. Mild uvula edema was significantly lower in the TWT group.
Both TWT and LT procedures provide sufficient hemostasis and reduced operative time, although lower postoperative pain and mild uvula edema were noted in TWT procedures. Furthermore, since both methods use single-use instruments, they provide safety against diseases such as Creutzfeld-Jakob disease.
本研究的目的是比较和评估与热凝扁桃体切除术(TWT)和结扎法扁桃体切除术(LT)相关的参数。
这是一项前瞻性随机研究。
对143例连续接受扁桃体切除术的成年患者进行了一项前瞻性研究。适应症包括慢性扁桃体炎和阻塞性睡眠呼吸暂停综合征。排除接受腺样体切除术或与扁桃体切除术同时进行任何手术的患者以及有扁桃体周围脓肿病史或出血性疾病的患者。患者被随机分配到TWT组或LT组。评估术中出血、手术时间、使用视觉模拟量表评估的术后疼痛以及并发症发生率。
任何一组均未出现可测量的术中出血。未观察到平均手术时间有显著差异。TWT组的平均术后疼痛评分显著更低。TWT组有1例患者出现术后晚期出血,LT组有2例。TWT组的轻度悬雍垂水肿明显更低。
TWT和LT手术均能提供充分的止血效果并缩短手术时间,不过TWT手术的术后疼痛较轻且悬雍垂水肿较轻。此外,由于两种方法均使用一次性器械,它们对克雅氏病等疾病具有安全性。