Basu Soumik, Sengupta Anindita, Dubey Arya Brata, Sengupta Arunabha
Department of Ent Head Neck Surgery, Institute of Postgraduate Medical Education Research, 244 AJC Bose Road, Kolkata, 700020 India.
Indian J Otolaryngol Head Neck Surg. 2019 Dec;71(4):498-503. doi: 10.1007/s12070-019-01679-x. Epub 2019 Jun 18.
Tonsillectomy is an age old procedure in ENT practice. Though traditional dissection method is gold standard, we surgeons are trying different techniques like electrocautery, coblation, harmonic scalpel (HS) mainly to improve surgical convenience, to decrease operative time, post operative pain, intra and post operative bleeding and fast return to normal life. In this particular study we are comparing coblation and HS as surgical tool in tonsillectomy. It is a prospective double-blind randomized controlled trial where information was compared between two groups of coblation and HS tonsillectomy. A total number of 128 patients were compared over operation time, intra-operative blood loss, postoperative pain, time needed to regain the normal diet and activity and postoperative haemorrhage. We found statistically significant differences in operation time ( < 0.001) and intra operative blood loss ( < 0.001). Secondary haemorrhage rate was far better in HS (1.5%) group compared to coblation (7.8%). Whereas postoperative pain, time needed to go back to the normal diet and activity were better in HS group but the difference is not significant. This study revealed a significantly less operative time and intra-operative and post operative blood loss in harmonic scalpel tonsillectomy in comparison with coblation method. These findings addressed HS tonsillectomy as an advanced method.
扁桃体切除术是耳鼻喉科临床中一项由来已久的手术。尽管传统的剥离法是金标准,但我们外科医生正在尝试不同的技术,如电灼、低温等离子消融、超声刀(HS),主要是为了提高手术便利性、缩短手术时间、减轻术后疼痛、减少术中及术后出血,并能更快恢复正常生活。在这项具体研究中,我们比较了低温等离子消融和超声刀作为扁桃体切除术中的手术工具。这是一项前瞻性双盲随机对照试验,比较了低温等离子消融扁桃体切除术和超声刀扁桃体切除术两组之间的信息。总共128例患者在手术时间、术中失血、术后疼痛、恢复正常饮食和活动所需时间以及术后出血等方面进行了比较。我们发现手术时间(<0.001)和术中失血(<0.001)存在统计学上的显著差异。超声刀组(1.5%)的继发性出血率远低于低温等离子消融组(7.8%)。虽然超声刀组术后疼痛、恢复正常饮食和活动所需时间更好,但差异不显著。这项研究表明,与低温等离子消融法相比,超声刀扁桃体切除术的手术时间、术中及术后失血明显更少。这些发现表明超声刀扁桃体切除术是一种先进的方法。