JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (3): 56-60.doi: 10.6040/j.issn.1673-3770.0.2016.123

Previous Articles     Next Articles

Comparison of coblation, ultrasonic knife and conventional approach in tonsillectomy.

ZHANG Liqing, YANG Cuifang, ZHOU Huaqun, LU Meiping, DONG Weida   

  1. Department of Otorhinolaryngology, First Affiliated Hospital of Nanjing Medical University / Jiangsu Provincial Peoples Hospital, Nanjing 210029, Jiangsu, China
  • Received:2016-03-23 Online:2016-06-16 Published:2016-06-16

Abstract: Objective To evaluate the advantages and disadvantages of coblation, ultrasonic knife and conventional approach in tonsillectomy. Methods A total of 117 cases in need of tonsillectomy were collected and divided into 3 groups: coblation tonsillectomy group(group A, n=39), ultrasound knife tonsillectomy group(group B, n=39)and the traditional tonsillectomy group(group C, n=39). The operation time, blood loss, postoperative sore throat situation, postoperative primary and secondary bleeding and so on were recorded and compared. Results The operation time was shorter, and intraoperative blood loss was less in group A and B than in group C(P<0.05). The operation time in group A [(9.92±4.04)min] was shorter than that [(15.86±1.36)min] in group B,(P<0.05). There was no difference in intraoperative blood loss between group A and B(P>0.05). The degree of the pain in the first three days after surgery in group A and in group B was significantly lower than that in group C(P<0.05), but no statistically significant differences were observed after three days(P>0.05). Postoperative throat pain in group A was lighter than that in group B, but there was no significant difference(P>0.05). Postoperative primary hemorrhage occurred in 1 case in group A and C, while secondary hemorrhage occurred in 1, 1 and 2 cases in group A, B and C, respectively. There was no significant difference in the time of pseudo-membrane defulvium among the three groups(P>0.05). Pharyngeal edema score 24 hours after operation in group A and group B was significantly lower than in group C(P<0.05), but there was no statistically significant difference between group A and group B(P>0.05). Conclusion Coblation tonsillectomy is the more safe and effective method, but its cost is relatively high. It is suitable for patients with good economic conditions and high quality of life. Ultrasonic knife tonsillectomy is suggested to be appropriate for patients with adhesive tonsillitis of long duration.

Key words: Tonsillectomy, Sonication, Coblation

CLC Number: 

  • R766.7
[1] 庹华为, 黄志纯, 王丽芬. 扁桃体手术的演变和进展[J]. 国际耳鼻咽喉头颈外科杂志, 2015, 39(2):112-115. TUO Huawei, HUANG Zhichun, WANG Lifen. The evolution and progress of tonsil surgery[J]. Inter J Otolaryngol Head Neck Surgery, 2015, 39(2):112-115.
[2] 磨宾宇, 戴文斌, 周永, 等. 低功率单极电刀凝切术与低温等离子刀和传统剥离术对成人扁桃体切除术的效果对比分析[J]. 中国全科医学, 2012, 15(29):3416-3418. MO Bingyu, DAI Wenbin, ZHOU Yong, et al. Roles of monopole electrocoagulation, coblation, and conventional tonsillectomy in the surgial removal of the tonsils among adult patients[J]. Chin Gen Prac, 2012, 15(29):3416-3418.
[3] 王志斌.扁桃体切除术简史[J]. 中华医史杂志, 2003, 33(4):239-241. WANG Zhibin. A brief history of tonsillectomy[J]. Chin J Med History, 2003, 33(4):239-241.
[4] Owaki T, Nakano S, Arimura K, et al. The ultrasonic coagulating and cutting system injures nerve function[J]. Endoscopy, 2002, 34(7):575-579.
[5] 吴建, 范静平, 朱秋蓓. 超声刀在鼻咽喉-头颈外科手术中的应用价值[J]. 上海医学, 2013, 36(1):67-69. WU Jian, FAN Jingping, ZHU Qiubei. Application ofUltrasonicActivated Shears in Otolaryngology-head and Neck Surgeries[J]. Shanghai Med J, 2013, 36(1):67-69.
[6] Izny H Z, Rosdan S, Mohd K M. Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain[J]. Med J Malaysia, 2014, 69(2):74-78.
[7] Timms M S, Temple R H. Coblation tonsillectomy: a double blind randomized controlled study[J]. J Laryngol Otol, 2002, 116(6):450-452.
[8] 陈曦. 甲状腺手术中热损伤预防[J]. 中国实用外科杂志, 2012, 32(5):369-372. CHEN Xi. The prevention of thermal injury in thyroidectomy[J]. Chin J Pract Surg, 2012, 32(5):369-372.
[9] Ozkiris M, Kapusuz Z, Saydam L. Comparison of three techniques in adult tonsillectomy[J]. Eur Arch Otorhinolaryngol, 2013, 270(3):1143-1147.
[10] 庹华为, 黄志纯, 冯旭, 等. 超声刀扁桃体切除术的临床病理研究[J]. 中国耳鼻咽喉头颈外科, 2015, 22(5):261-264. TUO Huawei, HUANG Zhichun, FENG Xu, et al. The clinical pathological study of ultrasonic knife tonsillectomy[J]. Chin Otolaryngol Otolaryngol Head Neck Surg, 2015, 22(5):261-264.
[11] Roje Z, Racic G, Dogas Z, et al. Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: a prospective randomized single-blind study[J]. Coll Antropol, 2009, 33(1):293-298.
[12] 刘大波, 谭宗瑜, 钟建文, 等. 儿童扁桃体腺样体低温等离子手术迟发性出血的初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(5):373-376. LIU Dabo, TAN Zongyu, ZHONG Jianwen, et al. A prelminary study of the secondary postoperative haemorrhage in pediatric coblation adenotonsillectomy[J]. Chin J Otorhinolarynol Head Neck Surg, 2010, 45(5):373-376.
[13] 宋晓环. 病理学[M]. 长春: 吉林大学出版社, 2012.
[1] LI Yanzhong, ZHANG Tai. Problems we face in children with obstructive sleep apnea hypopnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 1-5.
[2] XU Zhifei, NI Xin. Post-surgery management in children with obstructive sleep apnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 9-13.
[3] QIU Shuyao, LIU Dabo, ZHONG Jianwen, YANG Liqiang. Analysis of coblation complications in children with obstructive sleep apnea-hypopnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 34-37.
[4] HUO Hong, LI Wuyi, WANG Jian, YANG Dahai, JIN Xiaofeng, TIAN Xu, NIU Yanyan.. Treatment of pharyngeal stenosis following uvulopalatopharyngoplasty with coblation. [J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 58-61.
[5] ZHANG Liqing, SONG Shenghua, WANG Yuan, LIU Xiaojing, DONG Weida, ZHOU Han. Comparison of the efficacy of coblation, ultrasonic knife operation, and conventional tonsillectomy in a 2-year postoperative follow-up. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(5): 67-71.
[6] ZHANG Jie, CHEN Xuemei, XU Anting. A comparative analysis of harmonic scalpel tonsillectomy and coblation tonsillectomy. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(5): 95-100.
[7] . Coblation for benign hyperplasia of the tongue base. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(2): 83-84.
[8] XU Lei, ZHU Juanfen, CHENG Lei. Comparison of three surgical methods in adult patients undergoing tonsillectomy. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 49-52.
[9] WANG Lei, LOU Feng, ZHANG Yuan, ZHAO Xin. Effect of different doses of dexmedetomidine preoperative intranasal medication on the safety in children tonsillectomy. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 115-119.
[10] GONG Mingjie, LIU Kan, ZHANG Lei, YAN Biao, ZOU Jiaping, LI Weizhong. Comparison of the efficacy of three different techniques in tonsillectomy. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 70-73.
[11] DONG Shiliang, ZHAN Mingming. Hemostatic effect of preventive suture ligation in tonsillectomy [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(6): 90-91.
[12] HAN Naigang, LI Xiaohong. Coblation unilateral vocal cord transection with arytenoidenctomy in the treatment of bilateral vocal cord paralysis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(3): 59-61.
[13] LI Jun-zheng, GAO Xiang, WU Gai-zhen, CHEN Sha, WANG Jie, TIAN Wen-dong, LI Xiang-ping. Application of harmonic scalpel in children with obstructive sleep apnea and hyponea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(1): 1-4.
[14] ZHOU Jing-chun, KE Zhao-yang, MA Ling-guo, ZHANG Jing-jing, ZHANG Wei, FENG Chun-ying. Coblation and routine excision to treat epiglottic cysts [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(6): 43-46.
[15] ZHANG Jie, LI Jin-rang, LIU Tao. Pain evaluation with surface electromyogram in patients after tonsillectomy [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(6): 57-60.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!