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A study of haemostasis following tonsillectomy comparing ligatures with diathermy

Published online by Cambridge University Press:  29 June 2007

M. G. Watson*
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
P. J. D. Dawes
Affiliation:
District General Hospital, Sunderland SR4 7TP and the Department of Medical Statistics
P. R. Samuel
Affiliation:
District General Hospital, Sunderland SR4 7TP and the Department of Medical Statistics
H. F. Marshall
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
C. Rayappa
Affiliation:
District General Hospital, Sunderland SR4 7TP and the Department of Medical Statistics
J. Hill
Affiliation:
District General Hospital, Sunderland SR4 7TP and the Department of Medical Statistics
D. Meikle
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
G. E. Murty
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
J. A. J. Deans
Affiliation:
District General Hospital, Sunderland SR4 7TP and the Department of Medical Statistics
G. Telios
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
C. Aldren
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
J. P. Birchall
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
A. J. N. Pritchard
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
J. Livesey
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle NE7 7DN, the Department of Otolaryngology
D. Appleton
Affiliation:
Medical School, University of Newcastle-upon-Tyne.
*
G. Watson, F. R.C.S., Consultant ENT Surgeon, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT. Fax: (0302) 761205

Abstarct

The use of diathermy to achieve haemostasis after tonsillectomy remains controversial. We have reviewed the English language literature, and found no convincing evidence that diathermy is any more likely to cause post-operative haemorrhage than the use of ligatures. The results of a prospective, randomized study of 1036 consecutive tonsillectomies are presented. No significant difference was found in post-operative haemorrhage rates when either diathermy or ligatures were used. Diathermy was found to reduce operating time compared to ligatures. The possibilities for day-case tonsillectomy are discussed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1993

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References

Carmody, D., Vamadevan, T., Cooper, S.M. (1982) Post-tonsillectomy haemorrhage. Journal of Laryngology and Otology 96: 635638CrossRefGoogle ScholarPubMed
Cohen, L. (1909) Post-operative tonsillar bleeding. It's surgical control, with mention of cases. Journal of the American Medical Association 53: 698701CrossRefGoogle Scholar
Haase, F.R., Noguera, J.T. (1962) Haemostasis in tonsillectomy by electrocautery. Archives of Otolaryngology 75: 125126CrossRefGoogle ScholarPubMed
Johnson, F. (1962) Electrocautery in tonsil and adenoid surgery. Archives of Otolaryngology 75: 127129CrossRefGoogle ScholarPubMed
Mackenzie, I.J., Johnson, A.P., Maran, A.G.D. (1983) Prospective study of pain and haemorrhage following tonsillectomy. Clinical Otolaryngology 8: 366.Google Scholar
Malik, M.K., Bhatia, B. P. R., Kumar, A. (1982) Control of haemorrhage in tonsillectomy. Journal of the Indian Medical Association 79: 115117Google ScholarPubMed
McAuliffe-Curtin, J. (1987) The history of tonsil and adenoid surgery. Otolaryngology Clinics of North America 20: 415419CrossRefGoogle Scholar
Murty, G. E., Watson, M.G. (1990) Diathermy haemostasis at tonsillectomy: current practice—a survey of UK otolaryngologists. Journal of Laryngology and Otology 104: 549552CrossRefGoogle Scholar
Papangelou, L. (1972) Hemostasis in tonsillectomy. Archives of Otolaryngology 96: 358360CrossRefGoogle ScholarPubMed
Phillips, J.J., Thornton, A. R. D. (1989) Tonsillectomy haemostasis: diathermy or ligation. Clinical Otolaryngology 14: 419424CrossRefGoogle Scholar
Roberts, C.Jayaramachandran, S., Raine, C.H. (1992) A prospective study of the factors which may predispose to post-operative tonsillar fossa haemorrhage. Clinical Otolaryngology 17: 1317CrossRefGoogle ScholarPubMed
Roy, A., De la Rosa, C., Vecchio, Y. A. (1976) Bleeding following tonsillectomy. A study of electrocoagulation and ligation techniques. Archives of Otolaryngology 102: 910CrossRefGoogle ScholarPubMed
Siodlak, M.Z., Gleeson, M.J., Wengraf, C.L. (1985) Post-tonsillectomy secondary haemorrhage. Annals of the Royal College of Surgeons of England 67: 167168Google ScholarPubMed
Waugh, G.E. (1909 a) A simple operation for the removal of tonsils, with notes on 900 cases. Lancet 1: 13141315.CrossRefGoogle Scholar
Waugh, G.E. (1909 b) An operation for the total excision of tonsils (letter). Lancet 2: 572.CrossRefGoogle Scholar
Whillis, S.S., Pybus, F.C. (1910) Enucleation of tonsils with the guillotine. Lancet ii: 875878CrossRefGoogle Scholar
Worthington, T.C. (1907) A simple method of excision of the faucial tonsil. Journal of the American Medical Association 48: 17611762CrossRefGoogle Scholar
Yardley, M. P. J. (1992) Tonsillectomy, adenoidectomy, and adenotonsillectomy: are they safe day case procedures? Journal of Laryngology and Otology 106: 299300CrossRefGoogle ScholarPubMed