5.Comparison of Outcomes in Diathermy versus Dissection Method Tonsillectomy at a Tertiary Care Hospital in Karachi
Furqan Mirza1, Iqbal Hussain Udaipurwala2, Ashok Kumar Raheja3, Salman Mutiullah Shaikh1, Fatima Siddiqui4 and Amna Bukhari5
ABSTRACT
Objective: Over the years, various methods of tonsillectomy have been practiced to reduce or eliminate intra-operative and post-operative morbidity. The objective of this study is to compare outcomes in diathermy versus dissection tonsillectomy in a tertiary care hospital of Karachi.
Study Design: Comparative Randomized double blind study
Place and Duration of Study: This study was conducted at the Jinnah Medical College Hospital, an affiliated hospital of Jinnah Medical & Dental College, Karachi, Pakistan from August, 2019 to January, 2021.
Materials and Methods: The total number of patients enrolled in the study were 100 with ages ranging between 4 to 28 years old (mean age 11.2 ± 2.1 years). Patients were then randomly divided into two equal groups of 50 patients each; group A consisting of diathermy tonsillectomy while group B comprising of dissection tonsillectomy. During and after surgery different parameters were measured including post-operative earache, excessive thick slough formation in the tonsillar fossa, fever, duration of analgesic use, time of return to a regular diet, operating time, blood loss during surgery, post-operative hemorrhage and post-operative pain scores.
Results: The mean pain score of both the groups in immediate post-operative period (7.96 ±0.9 vs 7.63 ±0.8) and 24 hours period (6.78 ±1.1 vs 6.12 ± 0.9) was almost the same while pain score at 7th post-operative is significantly high in diathermy group (5.47 ± 0.9 vs 2.55 ± 0.8). 4% of Diathermy patients suffered from secondary bleeding and none of the Cold Steel patients had such complaint (p- value 0.056). Mean operating time was shorter in diathermy group (21.7 ± 2.1 vs 28.4 ± 2.4 minutes) and intra-operative blood loss was also less in diathermy group (15.5 ±3.1 vs 98.1 ± 9.4 ml).
Conclusion: We conclude that cold steel tonsillectomy has better patient outcomes as compared to diathermy, however diathermy method has less operating time and less intra-operative bleeding.
Key Words: tonsillectomy, diathermy tonsillectomy, cold Steel tonsillectomy, post-operative complications
Citation of article: Mirza F, Udaipurwala IH, Raheja AK, Shaikh SM, Siddiqui F, Bukhari A. Comparison of Outcomes in Diathermy versus Dissection Method Tonsillectomy at a Tertiary Care Hospital in Karachi. Med Forum 2022;33(2):19-23.