Sanlı Arif, Yildiz Gazi, Erdogan Banu Atalay, Paksoy Mustafa, Altin Gokhan, Ozcelik Muhammed Ali
Department of Otolaryngology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
Prague Med Rep. 2017;118(1):26-36. doi: 10.14712/23362936.2017.3.
The aim of this study is to compare objectively advantages and disadvantages of cold technique tonsillectomy and thermal welding tonsillectomy at the same case. A total of 100 patients, 53 patients younger than 12 years of age and 47 patients elder than 12 years of age, were included in this study. Tonsillectomy was performed by using cold technique on the right side of the palatine tonsils and thermal welding on the left side. Right and left sides were compared regarding perioperative bleeding, surgical dissection time, postoperative pain scale at the 1st and 7th day and postoperative bleeding parameters. Perioperative bleeding was found to be higher in cold technique side in patients younger than 12 years of age (p<0.001). Postoperative pain score on the day 1 was significantly higher in cold technique side, whereas it was found to be higher in thermal welding side at postoperative day 7 (p<0.001). Perioperative bleeding was found to be significantly higher in cold technique side (p<0.001) and surgical dissection time of thermal welding was found to be longer (p<0.001) in patients elder than 12 years of age. Postoperative pain score at the day 1 and day 7 was found to be higher in thermal welding side (p<0.001). Postoperative pain score at the day 1 and day 7 were statistically significantly higher in patients elder than 12 years of age. As a result, both techniques have its unique superior aspects and both can be applied as a routine tonsillectomy technique.
本研究的目的是在同一病例中客观比较冷技术扁桃体切除术和热焊接扁桃体切除术的优缺点。本研究共纳入100例患者，其中53例年龄小于12岁，47例年龄大于12岁。在腭扁桃体右侧采用冷技术进行扁桃体切除术，左侧采用热焊接技术。比较左右两侧的围手术期出血情况、手术剥离时间、术后第1天和第7天的疼痛评分以及术后出血参数。发现年龄小于12岁的患者中，冷技术侧的围手术期出血较多（p<0.001）。冷技术侧术后第1天的疼痛评分显著较高，而术后第7天热焊接侧的疼痛评分较高（p<0.001）。年龄大于12岁的患者中，冷技术侧的围手术期出血显著较多（p<0.001），热焊接的手术剥离时间较长（p<0.001）。热焊接侧术后第1天和第7天的疼痛评分较高（p<0.001）。年龄大于12岁的患者术后第1天和第7天的疼痛评分在统计学上显著较高。结果表明，两种技术都有其独特的优势，均可作为常规扁桃体切除术技术应用。
