Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 268, Issue 2, pp 255–260 | Cite as

Tissue welding tonsillectomy provides an enhanced recovery compared to that after monopolar electrocautery technique in adults: a prospective randomized clinical trial

  • Juha Silvola
  • Aarre Salonen
  • Jouko Nieminen
  • Hannu KokkiEmail author
Laryngology

Abstract

We have compared tonsillectomy (TE) with tissue welding (TW) technology using a specially designed forceps versus conventional monopolar electrocautery to evaluate whether this new technology may improve recovery after TE. This was a single-blind, randomized clinical trial with two parallel groups. Sixty healthy adult day-surgery patients were allocated into the TW-TE group (n = 31) and the monopolar electrocautery-TE group (n = 29). We recorded intraoperative events and short- and long-term recovery for 2 weeks postoperatively. The patients and study nurses evaluating patients during recovery were blinded to the operation method used. All patients in the TW-TE group completed the study as per protocol, but in the monopolar electrocautery-TE group, there was one drop-out in the hospital and another after discharge. There was no difference in the perioperative parameters and early recovery between the two groups. After discharge, recovery was significantly faster in the TW group than in the monopolar group: (1) the duration of postoperative pain was 2 days shorter, and (2) activities of normal daily living were less affected, and (3) the need for hospital contacts after discharge, and (4) the incidence of postoperative bleeding was less in the TW group than that in the monopolar group. No patients in the TW group developed secondary bleeding versus three patients in the monopolar group requiring electrocautery to control bleeding. In conclusion; our results indicate that, TW technique may provide reduced pain, faster recovery, and fewer complications compared to electrocautery TE.

Keywords

Otorhinolaryngological surgical procedures Tonsillectomy Tissue welding Surgical instruments Ketoprofen Oxycodone 

Notes

Acknowledgments

The work was performed at Päijät-Häme Central Hospital in Lahti, Lahti, Finland. We did not receive any financial or material support for this research from any external body. The authors do not have any financial interests in companies or other entities that have an interest in the information presented here.

Conflict of interest statement

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stakes. Tilastotiedote 33/2008. http://www.stakes.fi/tilastot/tilastotiedotteet/2008/Tt33_08.pdf Accessed 11 Mar 2010
  2. 2.
    Salonen A, Kokki H, Nuutinen J (2002) Recovery after tonsillectomy in adults: a three-week follow-up study. Laryngoscope 112:94–98CrossRefPubMedGoogle Scholar
  3. 3.
    Messner AH (2005) Tonsillectomy. Oper Tech Otolaryngol Head Neck Surg 16:224–228CrossRefGoogle Scholar
  4. 4.
    Leinbach RF, Markwell SJ, Colliver JA, Lin SY (2003) Hot versus cold tonsillectomy: a systematic review of the literature. Otolaryngol Head Neck Surg 129:360–364CrossRefPubMedGoogle Scholar
  5. 5.
    Scott A (2006) Hot techniques for tonsillectomy. Issues Emerg Health Technol 93:1–6PubMedGoogle Scholar
  6. 6.
    McCue JL, Phillips RK (1991) Sutureless intestinal anastomoses. Br J Surg 78:1291–1296CrossRefPubMedGoogle Scholar
  7. 7.
    Karatzias GT, Lachanas VA, Sandris VG (2006) Thermal welding versus bipolar tonsillectomy: a comparative study. Otolaryngol Head Neck Surg 134:975–978CrossRefPubMedGoogle Scholar
  8. 8.
    Stavroulaki P, Skoulakis C, Theos E, Kokalis N, Valagianis D (2007) Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients. Ann Otol Rhinol Laryngol 16:565–570Google Scholar
  9. 9.
    Karatzanis A, Bourolias C, Prokopakis E, Panagiotaki I, Velegrakis G (2008) Thermal welding technology vs ligasure tonsillectomy: a comparative study. Am J Otolaryngol 29:238–241CrossRefPubMedGoogle Scholar
  10. 10.
    Salonen A (2002) Ketoprofen in tonsillectomy and adenoidectomy with special reference to the effects on surgical time, postoperative pain, adverse events and recovery after surgery. Dissertation. University of Kuopion. ISBN 951-781-883-1Google Scholar
  11. 11.
    Daut RL, Cleeland CS, Flanery RC (1983) Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases. Pain 17:197–210CrossRefPubMedGoogle Scholar
  12. 12.
    Karatzias GT, Lachanas VA, Papouliakos SM, Sandris VG (2005) Tonsillectomy using the thermal welding system. ORL J Otorhinolaryngol Relat Spec 67:225–229PubMedGoogle Scholar
  13. 13.
    Michel RG, Weinstock BI, Tsau K (2008) Safety and efficacy of pressure-assisted tissue-welding tonsillectomy: a preliminary evaluation. Ear Nose Throat J 87:100–105PubMedGoogle Scholar
  14. 14.
    Sezen OS, Kaytanci H, Kubilay U, Coskuner T, Unver S (2008) Comparison between tonsillectomy with thermal welding and the conventional ‘cold’ tonsillectomy technique. ANZ J Surg 78:1014–1018CrossRefPubMedGoogle Scholar
  15. 15.
    Karatzanis AD, Bourolias CA, Prokopakis EP, Panagiotaki IE, Velegrakis GA (2007) Tonsillectomy with thermal welding technology using the TLS(2) thermal ligating shear. Int J Pediatr Otorhinolaryngol 71:999–1002CrossRefPubMedGoogle Scholar
  16. 16.
    Chimona T, Proimos E, Mamoulakis C, Tzanakakis M, Skoulakis CE, Papadakis CE (2008) Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision, and thermal welding tonsillectomy in children. Int J Pediatr Otorhinolaryngol 72:1431–1436CrossRefPubMedGoogle Scholar
  17. 17.
    Michel RG, Tsau K, Weinstock BI (2008) Tissue welding forceps usage in superficial parotidectomy: a clinical assessment. Am Surg 74:51–55PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Juha Silvola
    • 1
  • Aarre Salonen
    • 1
  • Jouko Nieminen
    • 1
  • Hannu Kokki
    • 2
    Email author
  1. 1.Department of OtorhinolaryngologyPäijät-Häme Central Hospital of LahtiLahtiFinland
  2. 2.Department of Anesthesiology and Intensive CareKuopio University Hospital and University of Eastern FinlandKuopioFinland

Personalised recommendations