| Objective: Tonsillectomy is one of the most common otolaryngology surgeries. Radiofrequency, ultrasound, electric knives and other methods have been used in tonsil surgery in the 1970s, and the above methods having their own advantages and disadvantages respectively. Although tonsillectomy methods have made much progress in the past, the duration of tonsil surgery, intraoperative and postoperative bleeding and postoperative pain are still major concerns of the surgery. The aim of the experiment was to discover the advantages and disadvantages of tonsillectomy in children by using the new type of apparatus-electricity dissectible knife, comparing with that with the application of conventional guillotine tonsillectomy.Methods: 49 cases of children who were hospitalized for tonsillectomy in ENT dept in the second affiliated hospital of Dalian medical university from April 2009 to March 2011, aged 2.5 to 14 years old, 33 males and 16 females were enrolled into the experiment. They were divided into experimental and control groups randomly. There were 28 cases in the experimental group, including 19 males and 9 females, and the median age was 4.9 years. There were 21 cases in the control group, including 14 males and 7 females, and the median age was 5.1 years. The tonsillectomy surgeries were performed by using the electricity dissectible knife in the experimental group and conventional guillotine in the control group. Before surgery, every cases was performed a series of laboratory tests like blood test, clotting test and virus markers test , liver function and kidney function examination, ECG and chest-ray to meet the inclusion criteria. All the operations of both groups were performed by the same surgeon (experienced, skilled at surgical techniques). The four indicators, including the duration of tonsillectomy, blood loss volume, postoperative wound reaction and postoperative bleeding events, were observed and recorded during the operation after the operation. The data was analyzed statistically by the use of SPASS 17.0 software, like the two independent sample t test being used to compare the duration of tonsillectomy and the volume of blood loss in both groups, the Pearson chi-square test to compare postoperative wound responsiveness and postoperative bleeding events in both groups.Results:1. The duration of tonsillectomy was 3.15±1.30 min in the experimental group and 15.30±2.03 min in the control group. The difference was statistically significant (t = 25.483, P = 0.000).2. Blood loss volume in the experimental group was 2.54±2.43 ml, while 7.98±3.07 ml in the control group. The difference was statistically significant (t = 26.924, P = 0.000).3. it was mainly mild response of postoperative wound reaction in the experimental group in the first and third day after operation, while it was mainly moderate response in the control group, and there were no cases of severe postoperative wound reaction in both groups. The difference of postoperative wound reaction in the first day of both groups was statistically significant (χ~2 = 3.960, P = 0.047). And the difference of postoperative wound reaction in the third day of both groups was still statistically significant (χ~2 = 12.599, P = 0.000).4. There were no recurrent hemorrhage cases postoperatively in both the experimental group and control group.Conclusion:Tonsillectomy using electricity dissectible knife has the following advantages:1.The operation could be performed quickly, achieving homeostasis simultaneously.2. Less blood loss in the operation, and even no bleeding.3. Faster recovery could be anticipated due to less direct damage to the surrounding soft tissue in the operation and mild postoperative wound reaction.4. The operation technique is easier to master, especially to the beginner. |
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