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Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis: an analysis of 15734 patients in the National Tonsil Surgery Register in Sweden
Department of Otorhinolaryngology, Aleris Sabbatsberg, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0001-8549-9039
Sollentuna Specialist Clinic, Stockholm, Sweden.
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2015 (English)In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 40, no 3, p. 248-254Article in journal (Refereed) Published
Abstract [en]

Objectives: To analyse post-tonsillectomy haemorrhage(PTH) rates related to technique for dissection and haemostasis.Study Design: Register study from the National TonsilSurgery Register in Sweden (NTSRS).

Methods: All patients, subjected to tonsillectomy (TE)without adenoidectomy from 1 March 2009 to 26 April 2013,were included in the study. The surgeon reports data abouttechnique and early PTH, while late PTH is reported by thepatient in a questionnaire 30 days after surgery.

Results: 15734 patients with complete data concerningtechnique for dissec tion and for haemostasis were identifiedin the NTSRS. Techniques used were cold steel dissectionwith uni- or bipolar diathermy haemostasis (65.3%),diathermy scissors (15.7%), coblation (9.1%), cold steeldissection with cold haemostasis (7.4%) and ultrascision(2.5%). Early and late PTH were reported in 3.2% and 9.4% of the cases, respectively, and return to theatre (RTT) in2.7%. The rat es for PTH and RTT related to technique wereanalysed. Compared with cold dissection+ cold haemostasis,late PTH rate was 2.8 times higher after cold dissection + hothaemostasis, 3.2 times higher after coblation, 4.3 timeshigher after diathermy scissors and 5.6 times higher afterultrascision. The risk for RTT was higher for all hottechniques except for coblation, while ultrascision resultedin a lower risk for early PTH.

Conclusions: All hot techniques resulted in a higher risk forlate PTH compared with cold steel dissection +coldhaemostasis. The risk for RTT was higher for all hottechniques except for coblation, while ultrascision resultedin a lower risk for early PTH. An early PTH was associatedwith an increased risk for late PTH.

Place, publisher, year, edition, pages
2015. Vol. 40, no 3, p. 248-254
National Category
Medical and Health Sciences Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
URN: urn:nbn:se:oru:diva-39637DOI: 10.1111/coa.12361ISI: 000354455700011PubMedID: 25515059Scopus ID: 2-s2.0-84929159869OAI: oai:DiVA.org:oru-39637DiVA, id: diva2:771391
Note

Funding Agency:

Swedish Association of Local Authorities and Regions

Available from: 2014-12-12 Created: 2014-12-12 Last updated: 2018-06-26Bibliographically approved

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