Department of Otolaryngology - Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111165. doi: 10.1016/j.ijporl.2022.111165. Epub 2022 Apr 26.
Over 550,000 tonsillectomies are performed every year. While post-tonsillectomy hemorrhage (PTH) has been studied in the coblator, bovie, and cold steel technique, there is a dearth of studies examining the post-tonsillectomy outcome using BiZact. This study examines the rate of BiZact PTH requiring control of hemorrhage in the OR and assess resident comfort using the device.
Retrospective chart review for all tonsillectomies performed between January 2018 and December 2020 were performed. Rates of PTH were analyzed. In addition, a 7-question BiZact resident experience survey was administered to 25 otolaryngology residents.
1384 patients were included in this study; 444 (32%) Bizact and 940 (68%) Coblation. 11 (2.48%) BiZact patients had PTH requiring OR for control of hemorrhage, compared to 44 (4.68%) Coblation patients. There were no patient deaths because of PTH. The mean age of patients with PTH was 7.44 (SD 4.07) years old. 22 (88%) residents responded to the survey. 17 (77.27%) felt more confident with Coblator while performing tonsillectomy most commonly reported for ease of use, followed by BiZact 4 (18.18%), most commonly reported for improved surgical plane.
BiZact is a safe and effective addition. At our institution, the rate of secondary PTH requiring OR intervention for BiZact is comparable to the national average for other tonsillectomy devices. The rate of BiZact PTH requiring OR intervention in our experience was nearly half of those done with Coblator. Overall residents at SCHC preferred Coblator over BiZact mainly attributed to Coblator's versatility and ability to control intraoperative tonsil bleeding without additional instruments despite BiZact's shorter operative time.
每年进行超过 55 万例扁桃体切除术。虽然已经在 COBLATOR、BOVIE 和冷钢技术中研究了扁桃体切除术后出血（PTH），但缺乏使用 BiZact 检查扁桃体切除术后结果的研究。本研究检查了使用 BiZact 控制 OR 中出血的 PTH 发生率，并评估了该设备对住院医师的舒适度。
对 2018 年 1 月至 2020 年 12 月期间进行的所有扁桃体切除术进行回顾性图表审查。分析了 PTH 的发生率。此外，对 25 名耳鼻喉科住院医师进行了 7 个问题的 BiZact 住院医师体验调查。
本研究纳入 1384 例患者；444 例（32%）为 BiZact，940 例（68%）为 Coblation。11 例（2.48%）BiZact 患者发生 PTH，需要 OR 控制出血，而 Coblation 患者为 44 例（4.68%）。没有因 PTH 导致患者死亡。发生 PTH 的患者平均年龄为 7.44 岁（标准差 4.07）。22 名（88%）住院医师对调查做出了回应。17 名（77.27%）在进行扁桃体切除术时对 COBLATOR 更有信心，最常报告的是使用方便，其次是 BiZact 4 名（18.18%），最常报告的是改善手术平面。
BiZact 是一种安全有效的补充。在我们的机构中，BiZact 需要 OR 干预的继发性 PTH 发生率与其他扁桃体切除术设备的全国平均水平相当。在我们的经验中，BiZact 需要 OR 干预的 PTH 发生率几乎是 Coblator 的一半。总体而言，SCHC 的住院医师更喜欢 Coblator 而不是 BiZact，主要归因于 Coblator 的多功能性和在不使用额外器械的情况下控制术中扁桃体出血的能力，尽管 BiZact 的手术时间更短。
