Attner Per, Hemlin Claes, Söderman Anne-Charlotte Hessén
Department of Otolaryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
Acta Otolaryngol. 2010 Oct;130(10):1180-4. doi: 10.3109/00016481003702544.
Ligasure tonsillectomies took longer than bipolar diathermy scissors tonsillectomies. Peroperative haemostasis was comparable in the two groups. Postoperative haemorrhage was higher than expected, which needs to be further investigated. A new handpiece, specifically designed for tonsillectomy, could probably improve surgical performance regarding operative time.
To compare tonsillectomy using Ligasure with bipolar diathermy scissors with regard to operative time, blood loss and complications.
This was a prospective study; 150 patients (> 15 years of age) undergoing tonsillectomy were randomized to tonsillectomy using either Ligasure or bipolar diathermy scissors. Operative time, peroperative blood loss, postoperative pain and complications were recorded and evaluated.
A total of 149 cases were included, 75 randomized to Ligasure tonsillectomy and 74 to bipolar diathermy scissors tonsillectomy. Peroperative blood loss was similar in both groups. On average the operative time was 8 min longer in the Ligasure group. Postoperative pain was similar in the two groups. Twenty patients (13%) experienced postoperative haemorrhage, which is higher than our previous material. Slightly fewer patients experienced postoperative haemorrhage in the Ligasure group compared with the diathermy scissors group but the difference was not significant. Two of the 20 patients that experienced postoperative haemorrhage required a return to theatre to stop the bleeding, fewer than previously observed. No other complications were seen.
使用结扎速血管闭合系统进行扁桃体切除术比使用双极电凝剪刀进行扁桃体切除术耗时更长。两组的术中止血情况相当。术后出血高于预期,这需要进一步研究。一种专门为扁桃体切除术设计的新手柄可能会在手术时间方面改善手术操作。
比较使用结扎速血管闭合系统与双极电凝剪刀进行扁桃体切除术在手术时间、失血情况及并发症方面的差异。
这是一项前瞻性研究;150例(年龄>15岁)接受扁桃体切除术的患者被随机分为使用结扎速血管闭合系统或双极电凝剪刀进行扁桃体切除术两组。记录并评估手术时间、术中失血、术后疼痛及并发症情况。
共纳入149例病例,75例随机接受结扎速血管闭合系统扁桃体切除术,74例接受双极电凝剪刀扁桃体切除术。两组术中失血情况相似。结扎速血管闭合系统组平均手术时间长8分钟。两组术后疼痛情况相似。20例患者(13%)出现术后出血,高于我们之前的病例数。结扎速血管闭合系统组术后出血的患者略少于双极电凝剪刀组,但差异无统计学意义。20例术后出血患者中有2例需要返回手术室止血,少于之前观察到的情况。未见其他并发症。