Regmi Deepak, Bista Meera, Shrestha Sangita
Department of Otorhinolaryngology Head and Neck Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
J Nepal Health Res Counc. 2022 Mar 13;19(4):820-823. doi: 10.33314/jnhrc.v19i04.3961.
To ameliorate the intra and post-op morbidities associated with newer techniques for tonsillectomy like coblation has been introduced in the recent past. This study was aimed to compare the cold steel dissection with the coblation technique with regards to its effectiveness and safety.
An observational comparative study was carried out in 90 patients undergoing tonsillectomy between July 2018 to December 2019. Forty-five patients in each group of cold steel dissection and coblation were compared between the operative time, intraoperative blood loss, post-operative pain, post-operative bleeding and return to work. Intraoperative blood loss was measured using a standard sized gauge piece whereas post-operative pain was measured using a visual analogue scale (0-10) at first and third day of surgery.
The age and sex were comparable between the groups. The mean operation time (31.40±4.52 min versus 17.02±3.11 min), intraoperative blood loss (27.20±7.16 ml vs 9.73±5.52 ml), post-operative pain in day 1 (8.02±1.27 vs 4.98±1.03), post-operative pain in day 3 (4.80±0.89 vs 2.76±0.74) and time needed to return to work in days (10. 31±1.29 vs 6.76±1.20) were statistically significant in coblation group (p<0.000). Primary and secondary post-operative haemorrhage rates were similar in both the groups. There was no return to theatre for hemostasis.
Coblation tonsillectomy significantly reduces operation time, intraoperative blood loss, post-operative pain (day1 and 3) and time required to return to work . This technique doesn't differ from cold steel dissection tonsillectomy in terms of primary and secondary post-operative hemorrhage.
为改善与诸如低温等离子消融术等较新的扁桃体切除技术相关的术中及术后发病率，近年来已引入该技术。本研究旨在比较冷钢剥离术与低温等离子消融术在有效性和安全性方面的差异。
对2018年7月至2019年12月期间接受扁桃体切除术的90例患者进行了一项观察性对比研究。比较冷钢剥离术组和低温等离子消融术组各45例患者的手术时间、术中出血量、术后疼痛、术后出血及恢复工作情况。术中出血量使用标准尺寸的量片进行测量，而术后疼痛则在手术第一天和第三天使用视觉模拟评分法（0 - 10分）进行测量。
两组患者的年龄和性别具有可比性。低温等离子消融术组的平均手术时间（31.40±4.52分钟对17.02±3.11分钟）、术中出血量（27.20±7.16毫升对9.73±5.52毫升）、术后第一天疼痛（8.02±1.27对4.98±1.03）、术后第三天疼痛（4.80±0.89对2.76±0.74）以及恢复工作所需天数（10.31±1.29对6.76±1.20）在统计学上具有显著差异（p<0.000）。两组的原发性和继发性术后出血率相似。没有患者因止血返回手术室。
低温等离子消融扁桃体切除术显著缩短了手术时间、术中出血量、术后疼痛（第一天和第三天）以及恢复工作所需时间。该技术在原发性和继发性术后出血方面与冷钢剥离扁桃体切除术没有差异。
