Comparative Study Between Bipolar Diathermy and Cold Dissection Techniques of Tonsillectomy

Abstract

Introduction: Tonsillectomy is a commonly performed surgical procedure in the Department of the Otorhinolaryngology. Among the different methods, bipolar diathermy and cold steel dissection techniques are most commonly used methods. This study aims to compare operation time, intraoperative bleeding and postoperative haemorrhage between bipolar diathermy tonsillectomy and cold dissection tonsillectomy.

Methods:This was an analytical cross-sectional study conducted in the Department of Otorhinolaryngology and Head and Neck surgery at Lumbini Medical College and Teaching Hospital over a period of fifteen month from 15 March 2020 to 15 June 2021. Total of 72 patients were enrolled for study. Patients were divided into two equal groups by computer randomization block: bipolar diathermy tonsillectomy (BDT) and cold steel dissection tonsillectomy (CDT).

 Results: The mean age of presentation was 21.67 years (SD=12.16) in bipolar diathermy tonsillectomy and 22.61(SD=9.45) years in cold dissection tonsillectomy (CDT) method respectively. In the age group analysis, the most common age group involved was 21 – 30 years (40.3%). Most common indications for tonsillectomy were recurrent tonsillitis (59.7%) and chronic tonsillitis (27.7%) followed by tonsillar hypertrophy (5.6%) and tonsillar papilloma (2.8%). The mean intraoperative bleeding amount in bipolar diathermy was 17.19 ml (SD=6.45) whereas in the cold dissection method it was 24.64 ml (SD= 10.54) which was statistically significant (p<0.05). There was one case of postoperative primary haemorrhage (2.77%) in each method. The mean operating time was shorter in bipolar diathermy tonsillectomy (32.25 minutes, SD=11.22) than cold dissection tonsillectomy method (36.72 minutes, SD=11.51).

Conclusion: Bipolar diathermy is a safe technique of tonsillectomy. It reduces operative time and intraoperative blood loss without increasing postoperative morbidity when compared to conventional cold dissection techniques tonsillectomy.