Incidence of Secondary Hemorrhage after Tonsillectomy by Dissection Method and Diathermy (Unipolar) Method
Md. Hosain Imam Tuhin
Published 18-10-2024
Keywords
- Tonsillectomy,
- Dissection method,
- Diathermy method,
- Secondary hemorrhage,
- Patient satisfaction
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Abstract
Introduction: Tonsillectomy remains one of the most commonly performed surgical procedures worldwide, addressing a spectrum of conditions ranging from recurrent tonsillitis to obstructive sleep apnea. The choice between surgical techniques, namely the dissection and diathermy methods, is often contingent upon surgeon preference, patient characteristics, and institutional protocols. This study aims to provide valuable insights into the comparative effectiveness and safety profiles of these two surgical techniques.
Methods and methods: This comparative study delved into patient records spanning from January 2023 to January 2024 at the Department of Otolaryngology and Head Neck surgery in Dhaka National Medical Institute Hospital scrutinizing the outcomes of tonsillectomy procedures performed via the dissection and diathermy (unipolar) methods. Descriptive statistics were harnessed to illuminate demographic characteristics and complication rates within the dissection and diathermy(unipolar) method groups. Analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows.
Result: Demographics were similar between groups. Secondary hemorrhage incidence was 15.1% for diathermy and 11.3% for dissection method. Conservative management was predominant (11.3% dissection, 9.4% diathermy). Regarding complications dissection method group: infections 3.8%, velopharyngeal insufficiency 1.9%, postoperative pain 18.9%. Diathermy method group: infections 9.4%, velopharyngeal insufficiency 7.5%, postoperative pain 37.7%.
Conclusion: In tonsillectomy the incidence of secondary hemorrhage is slightly higher in the diathermy (unipolar) method group. Moreover, the dissection method shows superiority over diathermy (unipolar), with fewer complications and higher patient satisfaction. Clinicians should consider these factors when choosing surgical techniques, prioritizing patient satisfaction alongside clinical efficacy.
