Convalescence after tonsillectomy: comparative study between traditional dissection and with harmonic scalpel (Ultracision)
DOI:
https://doi.org/10.34631/sporl.49Keywords:
tonsillectomy, surgical technique, postoperative morbidityAbstract
Introduction: Tonsillectomy is one of the most frequent procedures in the pediatric population. Because there are several surgical techniques and they are associated with different morbidity, the decision on wich to use continues to engender significant debate. The aim of this work is to compare the postoperative morbidity between two different tonsillectomy techniques: traditional and harmonic scalpel dissection.
Material and methods: Retrospective study. Patients who underwent tonsillectomy in the Otorhinolaringology Department of Braga Hospital, Portugal, from July to December 2011, were alternately selected from traditional and harmonic scalpel dissection groups, a total of 40 patients of each group. Data relative to duration of hospitalization, immediate postoperative complications, day of introduction of normal diet, urgency admission till the 15th postoperative day, were collected and compared.
Results: 80 children, aged between 3 and 14 years old, average age of 6 years old, 56% female. 73 children underwent adenotonsillectomy and 7 underwent tonsillectomy. There were no complications during hospitalization and all children discharged the day after surgery. Significantly more children who underwent tonsillectomy by harmonic scalpel dissection (12/40 vs 1/40) were admitted to the urgency the days after surgery, because of pain or hemorrhage (p <0.05). The introduction of normal diet was also significantly later in the harmonic scalpel tonsillectomy group (average of 7 days vs 4 days) (p <0.05).
Conclusions: In this study, harmonic scalpel dissection was related to increased postoperative morbidity. It was found increased use of urgency consultation and later introduction of normal diet. Those factors are important regarding the choice of the tonsillectomy technique, especially in the pediatric population.
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