Bipolar scissors versus cold dissection for pediatric tonsillectomy - a prospective, randomized pilot study

Objective: To evaluate bipolar scissors tonsillectomy by comparing it with traditional cold dissection tonsillectomy. The outcome measures used were: (1) intra-operative bleeding; (2) operative time; (3) post-operative pains and (4) complication rates including reactionary, and secondary hemorrhage. Method: A prospective. randomized multiunit study involving three teaching hospitals in Belfast, Fifty consecutive children aged 10-16 years undergoing tonsillectomy for recurrent or chronic tonsillitis, between March 2000 and September 2000 were recruited as a subgroup of 200 patients selected for this study. These children were analysed separately from the adults, in a pilot study for the above parameters. Results: The mean age of the study population was 14.3 years. Sixty-eight percent of the children were girls. Median intra-operative blood loss was 6 ml for bipolar scissors tonsillectomy and 86 ml for cold dissection tonsillectomy (P < 0.001). The median operative time was 10.5 min for bipolar scissors tonsillectomy compared to 14.5 min for the cold dissection method (P = 0.001). There was no statistically significant difference in the pain scores between the two methods (P > 0.05). The overall reactionary hemorrhage rate was 4%, while the overall secondary hemorrhage rate was 14%. The hospital readmission rate was The reactionary and secondary hemorrhage rates were unaffected by the surgical method. Conclusions: This pilot study has shown that bipolar scissors tonsillectomy is a relatively safe technique in children aged 10-16 years with a similar morbidity to the cold dissection method. Its use is associated with a significant decrease in surgical time and blood loss compared to the cold dissection method. These advantages make it a favourable instrument for pediatric tonsillectomy especially in this age group. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.