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组织焊接扁桃体切除术与单极电烙术相比,可使成人术后恢复更快:一项前瞻性随机临床试验。

Tissue welding tonsillectomy provides an enhanced recovery compared to that after monopolar electrocautery technique in adults: a prospective randomized clinical trial.

作者信息

Silvola Juha, Salonen Aarre, Nieminen Jouko, Kokki Hannu

机构信息

Department of Otorhinolaryngology, Päijät-Häme Central Hospital of Lahti, 15850 Lahti, Finland.

出版信息

Eur Arch Otorhinolaryngol. 2011 Feb;268(2):255-60. doi: 10.1007/s00405-010-1333-9. Epub 2010 Jul 14.

Abstract

We have compared tonsillectomy (TE) with tissue welding (TW) technology using a specially designed forceps versus conventional monopolar electrocautery to evaluate whether this new technology may improve recovery after TE. This was a single-blind, randomized clinical trial with two parallel groups. Sixty healthy adult day-surgery patients were allocated into the TW-TE group (n = 31) and the monopolar electrocautery-TE group (n = 29). We recorded intraoperative events and short- and long-term recovery for 2 weeks postoperatively. The patients and study nurses evaluating patients during recovery were blinded to the operation method used. All patients in the TW-TE group completed the study as per protocol, but in the monopolar electrocautery-TE group, there was one drop-out in the hospital and another after discharge. There was no difference in the perioperative parameters and early recovery between the two groups. After discharge, recovery was significantly faster in the TW group than in the monopolar group: (1) the duration of postoperative pain was 2 days shorter, and (2) activities of normal daily living were less affected, and (3) the need for hospital contacts after discharge, and (4) the incidence of postoperative bleeding was less in the TW group than that in the monopolar group. No patients in the TW group developed secondary bleeding versus three patients in the monopolar group requiring electrocautery to control bleeding. In conclusion; our results indicate that, TW technique may provide reduced pain, faster recovery, and fewer complications compared to electrocautery TE.

摘要

我们使用一种专门设计的镊子,将扁桃体切除术(TE)与组织焊接(TW)技术进行了比较,并与传统单极电烙术进行对比,以评估这项新技术是否能改善扁桃体切除术后的恢复情况。这是一项双平行组单盲随机临床试验。60名健康的成年日间手术患者被分配到TW-TE组(n = 31)和单极电烙术-TE组(n = 29)。我们记录了术中情况以及术后2周的短期和长期恢复情况。在恢复过程中评估患者的患者和研究护士对所使用的手术方法不知情。TW-TE组的所有患者均按方案完成了研究,但在单极电烙术-TE组中,有1名患者在住院期间退出,另1名在出院后退出。两组的围手术期参数和早期恢复情况没有差异。出院后,TW组的恢复明显比单极组快:(1)术后疼痛持续时间短2天,(2)日常生活活动受影响较小,(3)出院后与医院联系的需求,以及(4)TW组术后出血的发生率低于单极组。TW组没有患者发生继发性出血,而单极组有3名患者需要电烙术来控制出血。总之,我们的结果表明,与电烙术扁桃体切除术相比,TW技术可能会减轻疼痛、加快恢复并减少并发症。

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