Hapalia Vaibhav B, Panchal Ajay J, Kumar Rakesh, Kapadia Parth B, Bhiryani Mitanshi A, Verma Ridham B, Parmar Neel D
Department of Otorhinolaryngology, Surat Municipal Institute of Medical Education and Research, Sahara Darwaja, Surat, Gujarat 395001 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1163-1168. doi: 10.1007/s12070-020-02247-4. Epub 2020 Oct 30.
The objective of the study was to assess endoscopic coblation adenoidectomy and conventional cold curettage adenoidectomy in terms of safety and efficacy in pediatric patients. Study included 40 pediatric patients, aged between 4-17 years. 20 patients underwent cold curettage adenoidectomy and 20 underwent Coblation adenoidectomy. The 2 procedures were compared on various parameters like duration of surgery, intra-operative blood loss, and post -operative pain. To further the comparison, follow -up Nasal Endoscopy was done after 1 week and after 1 month to assess for injury to peripheral tissues and completeness of removal of adenoids. There was statistically significant difference, favouring Coblation adenoidectomy in terms of lesser intra-operative blood loss (mean blood loss of 19 mL Vs 28.5 mL) and lesser post -operative pain measured on Visual Analogue Scale (median VAS score of 2 Vs 2.67). Shorter duration of surgery (mean operative time of 10.3 min Vs 15.5 min) was the only parameter in favour of conventional cold curettage method. Injury to peripheral tissue and residual adenoid were seen in patients who underwent curettage adenoidectomy. The overall advantages of Coblation adenoidectomy when compared with cold curettage adenoidectomy are less intra-operative bleeding, less post -operative pain, completeness and preciseness of adenoid removal with minimal injury to adjacent tissues. For these reasons, Coblation adenoidectomy should be the standard technique adopted for adenoidectomy.
本研究的目的是评估小儿患者内镜下低温等离子腺样体切除术和传统冷刮除腺样体切除术的安全性和有效性。研究纳入了40例4至17岁的小儿患者。20例患者接受了冷刮除腺样体切除术，20例接受了低温等离子腺样体切除术。对这两种手术在手术时间、术中出血量和术后疼痛等各种参数方面进行了比较。为了进一步比较，在术后1周和1个月进行了随访鼻内镜检查，以评估周围组织的损伤情况和腺样体切除的完整性。在术中出血量较少（平均出血量分别为19毫升和28.5毫升）以及视觉模拟量表测量的术后疼痛较轻（中位VAS评分分别为2和2.67）方面，低温等离子腺样体切除术具有统计学上的显著差异。手术时间较短（平均手术时间分别为10.3分钟和15.5分钟）是支持传统冷刮除术的唯一参数。接受冷刮除腺样体切除术的患者出现了周围组织损伤和腺样体残留。与冷刮除腺样体切除术相比，低温等离子腺样体切除术的总体优势在于术中出血较少、术后疼痛较轻、腺样体切除完整且精确，对相邻组织的损伤最小。基于这些原因，低温等离子腺样体切除术应成为腺样体切除术采用的标准技术。
