Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-03T00:44:37.407Z Has data issue: false hasContentIssue false
  • English
  • Français

Bleeding following coblation tonsillectomy: a 10-year, single-surgeon audit and modified grading system

Published online by Cambridge University Press:  02 October 2014

M A Rogers ,
C Frauenfelder ,
C Woods ,
C Wee  and
A S Carney
M A Rogers
Affiliation:
Department of Surgery, Flinders University, Adelaide, South Australia, Australia
C Frauenfelder
Affiliation:
Department of Surgery, Flinders University, Adelaide, South Australia, Australia Department of Otolaryngology – Head and Neck Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia
C Woods
Affiliation:
Department of Surgery, Flinders University, Adelaide, South Australia, Australia Department of Otolaryngology – Head and Neck Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia
C Wee
Affiliation:
Department of Surgery, Flinders University, Adelaide, South Australia, Australia
A S Carney*
Affiliation:
Department of Surgery, Flinders University, Adelaide, South Australia, Australia Department of Otolaryngology – Head and Neck Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia
*
Address for correspondence: Prof A Simon Carney, c/o Southern ENT, Suite 200, Flinders Private Hospital, Bedford Park, SA 5042, Australia Fax: +61 8 82199908 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Coblation tonsillectomy can be controversial. This study assessed post-tonsillectomy haemorrhage outcomes for patients operated on by a single experienced coblation-trained ENT surgeon.

Study design:

A retrospective audit of coblation tonsillectomies was performed using the Flinders modification of Stammberger criteria for post-tonsillectomy haemorrhage.

Method:

Case note review, interview and database interrogation were utilised to obtain the dataset. Haemorrhage results were compared to reports in the current literature.

Results:

Of those who underwent coblation tonsillectomy, 3.4 per cent were readmitted to hospital with haemorrhage and 1.3 per cent returned to the operating theatre (0.4 per cent primary haemorrhage and 0.9 per cent secondary haemorrhage). Younger children had a lower risk of returning to the operating theatre than older children or adults (0.3 per cent under the age of 12 years vs 2.0 per cent aged 12 years or older).

Conclusion:

Coblation can be a safe method for tonsillectomy with low complication rates when performed by an experienced ENT surgeon. The Flinders modification of the Stammberger criteria for post-tonsillectomy haemorrhage provides a simple system for data comparison.

Keywords

TonsillectomyAblation TechniquesPostoperative HemorrhageComplicationsPalatine TonsilData CollectionAdverse Effects
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue S1 , January 2015 , pp. S32 - S37
Copyright
Copyright © JLO (1984) Limited 2014 

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

Presented at the Australian Otolaryngology Head and Neck Surgery (ASOHNS) Annual Scientific Meeting, 18 March 2013, Perth, Western Australia, Australia.

References

1Charaklias, N, Mamais, C, Kumar, BN. The art of tonsillectomy: the UK experience for the past 100 years. Otolaryngol Head Neck Surg 2011;144:851–4CrossRefGoogle ScholarPubMed
2Baugh, RF, Archer, SM, Mitchell, RB, Rosenfeld, RM, Amin, R, Burns, JJ et al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 2011;144:S1–30Google Scholar
3Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope 2011;121:2553–60Google Scholar
4Burton, MJ, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2007;(3):CD004619Google Scholar
5Shapiro, NL, Bhattacharyya, N. Cold dissection versus coblation-assisted adenotonsillectomy in children. Laryngoscope 2007;117:406–10CrossRefGoogle ScholarPubMed
6Tomkinson, A, Harrison, W, Owens, D, Harris, S, McClure, V, Temple, M. Risk factors for postoperative hemorrhage following tonsillectomy. Laryngoscope 2011;121:279–88CrossRefGoogle ScholarPubMed
7Mosges, R, Hellmich, M, Allekotte, S, Albrecht, K, Bohm, M. Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials. Eur Arch Otorhinolaryngol 2011;268:807–16CrossRefGoogle ScholarPubMed
8Magdy, EA, Elwany, S, El-Daly, AS, Abdel-Hadi, M, Morshedy, MA. Coblation tonsillectomy: a prospective, double-blind, randomised, clinical and histopathological comparison with dissection-ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008;122:282–90Google Scholar
9Brown, P, Ryan, R, Yung, M. National Prospective Tonsillectomy Audit. London: The Royal College of Surgeons of England, 2005Google Scholar
10Carney, AS, Harris, PK, MacFarlane, PL, Nasser, S, Esterman, A. The coblation tonsillectomy learning curve. Otolaryngol Head Neck Surg 2008;138:149–52Google Scholar
11Heidemann, CH, Wallen, M, Aakesson, M, Skov, P, Kjeldsen, AD, Godballe, C. Post-tonsillectomy hemorrhage: assessment of risk factors with special attention to introduction of coblation technique. Eur Arch Otorhinolaryngol 2009;266:1011–15Google Scholar
12Shah, UK, Dunham, B. Coblation for tonsillectomy: an evidence-based review. ORL J Otorhinolaryngol Relat Spec 2007;69:349–57Google Scholar
13Khan, I, Abelardo, E, Scott, NW, Shakeel, M, Menakaya, O, Jaramillo, M et al. Coblation tonsillectomy: is it inherently bloody? Eur Arch Otorhinolaryngol 2012;269:579–83Google Scholar
14Evans, AS, Khan, AM, Young, D, Adamson, R. Assessment of secondary haemorrhage rates following adult tonsillectomy--a telephone survey and literature review. Clin Otolaryngol Allied Sci 2003;28:489–91Google Scholar
15Amir, I, Belloso, A, Broomfield, SJ, Morar, P. Return to theatre in secondary post-tonsillectomy haemorrhage: a comparison of coblation and dissection techniques. Eur Arch Otorhinolaryngol 2012;269:667–71Google Scholar
16Stoker, KE, Don, DM, Kang, DR, Haupert, MS, Magit, A, Madgy, DN. Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled single-blind study. Otolaryngol Head Neck Surg 2004;130:666–75Google Scholar
17Harris, RL, Mitchell, JE, Jonathan, DA. A telephone audit in parallel with the UK national tonsillectomy audit to investigate re-admission as a measure of secondary haemorrhage rate. Auris Nasus Larynx 2008;35:220–3Google Scholar