Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-20T13:30:07.115Z Has data issue: false hasContentIssue false
  • English
  • Français

Argon plasma coagulation tonsillectomy versus coblation tonsillectomy: a comparison of efficacy and safety

Published online by Cambridge University Press:  07 June 2019

R Loh ,
L Stepan ,
E Zhen  and
C-K L Shaw
R Loh*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Modbury Hospital, Adelaide, Australia
L Stepan
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Modbury Hospital, Adelaide, Australia
E Zhen
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Perth Children's Hospital, Australia
C-K L Shaw
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Modbury Hospital, Adelaide, Australia Discipline of Surgery, Faculty of Health and Medical Sciences, University of Adelaide, Australia
*
Author for correspondence: Dr Rachel Loh, Shaw House, 37 Dequetteville Terrace, Kent Town, SA 5067, Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Tonsillectomy is one of the most common otolaryngological procedures. Nonetheless, there is still no universally approved ‘gold standard’ technique.

Objective

To compare the safety and efficacy of argon plasma coagulation and coblation techniques in tonsillectomy.

Methods

A multi-institutional, retrospective cohort study was conducted, comprising 283 patients who underwent bilateral tonsillectomies performed by a single surgeon between 2014 and 2017. The outcome measures included: operative time, intra-operative blood loss, post-operative pain and post-operative haemorrhage.

Results

In the argon plasma coagulation group, mean operative time and post-operative haemorrhage rate were significantly reduced, p = 0.0006 and p = 0.003 respectively. There was no statistically significant difference between the two groups in terms of post-operative pain and intra-operative blood loss.

Conclusion

The argon plasma coagulation technique is easy, safe and efficacious. Argon plasma coagulation tonsillectomy seems cost-effective compared to coblation tonsillectomy: the single-use disposable electrode tip and wand used in this study cost AUD$76.50 and AUD$380 respectively. Argon plasma coagulation appears to be a favourable alternative to current modalities such as coblation.

Keywords

TonsillectomyArgon Plasma CoagulationAblation TechniquesOtolaryngology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 6 , June 2019 , pp. 520 - 525
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr R Loh takes responsibility for the integrity of the content of the paper

Presented orally at the 17th ASEAN Otorhinolaryngology Head and Neck Surgery Congress, 16–18 November 2017, Yangon, Myanmar.

References

1Bergler, W, Huber, K, Hammerschmitt, N, Hormann, K. Tonsillectomy with argon plasma coagulation (APC): evaluation of pain and haemorrhage. Laryngoscope 2001;111:1423–9Google Scholar
2Kwok, M, Subramaniyan, M, Rimmer, J, Karahalios, A. Post-tonsillectomy haemorrhage in Australia--a multivariable analysis of risk factors. Aust J Otolaryngol 2018;1:2Google Scholar
3Metcalfe, C, Muzaffar, J, Daultrey, C, Coulson, C. Coblation tonsillectomy: a systematic review and descriptive analysis. Eur Arch Otorhinolaryngol 2017;274:2637–47Google Scholar
4Wilson, Y, Merer, D, Moscatello, A. Comparison of three common tonsillectomy techniques: a prospective randomized, double-blinded clinical study. Laryngoscope 2009;119:162–70Google Scholar
5Mösges, R, Hellmich, M, Allekotte, S, Albrecht, K, Böhm, M. Haemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials. Eur Arch Otorhinolaryngol 2011;268:807–16Google Scholar
6Wei, J, Beatty, C, Gustafson, R. Evaluation of posttonsillectomy haemorrhage and risk factors. Otolaryngol Head Neck Surg 2000;123:229–35Google Scholar
7Windfuhr, J, Chen, Y, Remmert, S. Haemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 2005;132:281–6Google Scholar
8Windfuhr, J, Schloendorff, G, Baburi, D, Kremer, B. Life-threatening posttonsillectomy haemorrhage. Laryngoscope 2008;118:1389–94Google Scholar
9Rakesh, S, Anand, T, Payal, G, Pranjal, K. A prospective, randomized, double-blind study of coblation versus dissection tonsillectomy in adult patients. Indian J Otolaryngol Head Neck Surg 2011;64:290–4Google Scholar
10Bergler, W, Huber, K, Hammerschmitt, N, Hölzl, M, Hörmann, K. Tonsillectomy with the argon-plasma-coagulation-raspatorium - a prospective randomized single-blinded study [in German]. HNO 2000;48:135–41Google Scholar
11Skinner, L, Colreavy, M, Lang, E, O'Hare, B, Charles, D, Timon, C. Randomized controlled trial comparing argon plasma coagulation tonsillectomy with conventional techniques. J Laryngol Otol 2003;117:298–301Google Scholar
12Ferri, E, Armato, E, Capuzzo, P. Argon plasma coagulation versus cold dissection tonsillectomy in adults: a clinical prospective randomized study. Am J Otolaryngol 2007;28:384–7Google Scholar
13Ferri, E, Armato, E. Argon plasma coagulation versus cold dissection in pediatric tonsillectomy. Am J Otolaryngol 2011;32:459–63Google Scholar
14American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health; Task Force on Pain in Infants, Children, and Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 2001;108:793–7Google Scholar
15Revill, S, Robinson, J, Rosen, M, Hogg, M. The reliability of a linear analogue for evaluating pain. Anaesthesia 1976;31:1191–8Google Scholar
16Breivik, H, Borchgrevink, P, Allen, S, Rosseland, L, Romundstad, L, Hals, EK et al. Assessment of pain. Br J Anaesth 2008;101:17–24Google Scholar
17Boelen-van der Loo, W, Scheffer, E, Haan, R, Groot, C. Clinimetric evaluation of the pain observation scale for young children in children aged between 1 and 4 years after ear, nose, and throat surgery. J Dev Behav Pediatr 1999;20:222–7Google Scholar
18de Jong, A, Bremer, M, Schouten, M, Tuinebreijer, W, Faber, A. Reliability and validity of the pain observation scale for young children and the visual analogue scale in children with burns. Burns 2005;31:198–204Google Scholar
19Chambers, C, Finley, A, McGrath, P, Walsh, T. The parents’ postoperative pain measure: replication and extension to 2–6-year-old children. Pain 2003;105:437–43Google Scholar
20Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. Haemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope 2011;121:2553–60Google Scholar
21Bowling, D. Argon beam coagulation for post-tonsillectomy haemostasis. Otolaryngol Head Neck Surg 2002;126:316–20Google Scholar
22Noon, A, Hargreaves, S. Increased post-operative haemorrhage seen in adult coblation tonsillectomy. J Laryngol Otol 2003;117:704–6Google Scholar