A completed audit cycle on post-tonsillectomy haemorrhage rate: coblation versus standard tonsillectomy

Acta Otolaryngol. 2007 Mar;127(3):300-4. doi: 10.1080/00016480600895052.

Abstract

Conclusion: A significant reduction in post-tonsillectomy secondary haemorrhage rate was observed after coblation tonsillectomy was abandoned in our department.

Objective: Comparison of the postoperative haemorrhage rate following coblation tonsillectomy and routine dissection tonsillectomy.

Patients and methods: This was a retrospective study. In the first audit period, 441 sequential tonsillectomies between January and September 2002 were reviewed. Coblation was compared with cold steel and diathermy dissection with either ties and/or diathermy used for haemostasis. Coblation tonsillectomy was subsequently abandoned in our unit and, in the second audit period, all tonsillectomies (n=416) between July 2003 and August 2004 were included. Statistical analysis was performed using the chi2 test.

Results: The overall primary haemorrhage rate in the first audit cycle was 1.8% (8/441). In the second cycle with no coblation procedures, 1.4% of patients (6/416) suffered from primary haemorrhage (c.f. 8/441 (1.8%) in the first cycle, p=0.666). Secondary haemorrhage, was seen among 15.4% of patients (68/441) in the first audit cycle. In the second cycle, after coblation was discontinued, the secondary haemorrhage rate fell significantly (p<0.001) to 5.8% (24/416). A breakdown of the results of cold steel/diathermy and coblation techniques in both adults and children is also presented.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Child
  • Cryosurgery / methods
  • Electrocoagulation / methods
  • Hemostasis, Surgical / methods*
  • Humans
  • Medical Audit*
  • Postoperative Hemorrhage / epidemiology*
  • Retrospective Studies
  • Tonsillectomy / methods*