Bashir Seerat, Swami Gautam
Department of ENT, GS Medical College and Hospital, Hapur, UP India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):2025-2028. doi: 10.1007/s12070-023-03778-2. Epub 2023 Apr 25.
Tonsillectomy is a commonly performed surgery in otolaryngological practice. Owing to the possibility of postoperative bleeding, it is considered as one of the major surgical procedures. Various techniques have been advocated, however dissection and electrocautery are the most commonly used techniques in tonsillectomy. The objective was to study and compare the relative efficacy using two methods of tonsillectomy- bipolar electrocautery versus silk ligation. This prospective study included 50 patients who underwent tonsillectomy. Patients were randomly divided into two groups. In Group A, left tonsillar fossa haemorrhage was controlled by ligation, while in Group B, bipolar diathermy was used to control bleeding of right tonsillar fossa. Comparison was done in terms of time taken for hemostasis, amount of intra-operative blood loss and post-operative pain. 130 (72.22%) male and 50 (27.77%) females were included. Group A included 20 cases while Group B included 30 cases. The mean time taken for hemostasis in Group A patients was 40.5 ± 4.4 min as compared to 25.3 ± 6.2 min in Group B patients. The mean blood loss on cautery side was 49.5 ± 4.5 ml and that on the ligation side was 68.6 ± 5.3 ml. Post-operative pain was significantly more in Group B patients as compared to Group A patients. Bipolar diathermy is a quicker and faster method to achieve hemostasis with little intraoperative blood loss as compated to silk ligation.
扁桃体切除术是耳鼻喉科临床中常见的手术。由于术后出血的可能性，它被视为主要外科手术之一。已经提倡了各种技术，然而剥离术和电烙术是扁桃体切除术中最常用的技术。目的是研究和比较扁桃体切除术的两种方法——双极电烙术与丝线结扎术的相对疗效。这项前瞻性研究纳入了50例行扁桃体切除术的患者。患者被随机分为两组。A组采用结扎法控制左侧扁桃体窝出血，而B组采用双极透热法控制右侧扁桃体窝出血。比较了止血时间、术中失血量和术后疼痛情况。纳入130名男性（72.22%）和50名女性（27.77%）。A组20例，B组30例。A组患者止血平均用时40.5±4.4分钟，而B组患者为25.3±6.2分钟。电烙侧平均失血量为49.5±4.5毫升，结扎侧为68.6±5.3毫升。与A组患者相比，B组患者术后疼痛明显更严重。与丝线结扎术相比，双极透热法是一种更快实现止血且术中失血量少的方法。
