Araştırma Makalesi
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Pediyatrik tonsillektomide dört farklı tekniğin karşılaştırılması

Yıl 2022, Cilt: 8 Sayı: 1, 8 - 16, 23.04.2022
https://doi.org/10.30569/adiyamansaglik.1016868

Öz

Amaç: Bu çalışmamızda tonsillektomi yöntemlerinin operasyon süreleri intraoperatif kanama postoperatif tam iyileşme süresi, postoperatif ağrı açısından karşılaştırırken uygun tonsillektomi tekniğini tespit etmeyi amaçladık.
Gereç ve Yöntem: Harran Üniversitesi Tıp Fakültesi Kulak Burun Boğaz hastalıkları polikliniğinde 1 Ocak 2017 ile 31 Temmuz 2018 tarihleri arasında başvuran ve tonsillektomi ameliyatı uygulanan 160 pediatrik hasta çalışmaya dahil edildi.
Bulgular: Çalışmaya alınan tüm hastalar randomize olarak 4 gruba (soğuk diseksiyon, bipolar koter, koblatör ve termal welding) ayrıldı. Ameliyat süresi, ameliyat sırasındaki kan kaybı ve postoperatif komplikasyonlar kaydedildi.
Sonuç: Çalışma sonucunda termal welding ile yapılan operasyonlarda cerrahi süre daha kısaydı. İntraoperatif kanama, postoperatif ağrı termal welding tekniğinde diğer tekniklere göre daha az olduğu tespit edildi. Ayrıca normal diyete ve normal aktiviteye dönüş zamanı en kısa olarak termal welding yönteminde tespit edildi.

Kaynakça

  • Kearns DB, Pransky SM, Seid AB. Current concepts in pediatric adenotonsiller disease. Ear Nose Throat J 1991;70(1):15-9.
  • Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol.1987;13(2):149-56.
  • Brodsky L. Modern assesment of tonsils and adenoids. Ped Clin North Am. 1989;36(6): 1551-69.
  • Friedman M, Tanyeri H, La Rosa M, Landsberg R, Vaidyanathan K, Pieri S, Caldarelli D. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999;109(12):1901-7.
  • Wilson YL, Merer DM, Moscatello AL. Comparison of Three Common Tonsillectomy Techniques: A Prospective Randomized, Double-Blinded Clinical Study. Laryngoscope 2009:119(1):162-70.
  • Ozkiris M, Kapusuz Z, Saydam L. Comparison of three techniques in adult tonsillectomy. Eur Arch Otorhinolaryngol 2013; 270(3):1143–7.
  • Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, Rogers KD, Schwarzbach RH, Stool SE, Friday GA. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of paralel randomized and nonrandomized clinical trials. N Eng J Med 1984;310(11):674-83.
  • Cunningham LC, Chio EG. Comparison of out comes and cost in patients undergoing tonsillectomy with electrocautery and thermal welding. Am J Otolaryngol 2015;36(1):20-3.
  • Silveira H, Soares JS, Lima HA. Tonsillectomy: cold dissection versus bipolar electrodissection. Int J Pediatr Otorhinolaryngol 2003:67(4):345–51.
  • Ozkiriş M, Comparison of three techniques in pediatric tonsillectomy. Eur Arch Otorhinolaryngol 2012:269(5):1497–501.
  • Karatzias GT, Lachanas VA, MD, Sandris VG. Thermal welding versus bipolar tonsillectomy: A comparative study. Otolaryngology Head and Neck Surg 2006; 134(6): 975-8.
  • Omrani M, Barati B, Omidifar N, Okhovvat AR, Hashemi SAG. Coblation versus traditional tonsillectomy: A double blind randomized controlled trial J Res Med Sci. 2012; 17(1): 45–50.
  • Yilmaz M, Duzlu M, Catli T, Ustun S, Ceylan A. Thermal welding versus cold knife tonsillectomy: A prospective randomized study. Kaohsiung Journal of Medical Sciences. 2012; 28(5): 270-2.
  • Mann, D, St. George C, Scheiner E, Granoff D, Imber P, Mlynarczyk FA. Tonsillectomy—some like it hot. Laryngoscope.1984; 94(5):677–9.
  • Weimert TA, Babyak JW, Richter HJ. Electro dissection tonsillectomy. Arch Otolaryngol Head Neck Surg. 1990;116(2):186-8.
  • Subasi B. Tonsillektomi Sonrası Kanaması Olan Hastaların Değerlendirilmesi. Kafkas Journal of Medical Sciences. 2020:10 (3):228-232.
  • Timms MS, Temple RH. Coblation tonsillectomy: a double blind randomized controlled study. J Laryngol Otol.2002;116(6):450-2.
  • Stavroulaki P, Skoulakis C, Theos E, Kokalis N, Valagianis D. Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients. Ann Otol Rhinol Laryngol.2007;116(8):565-70.
  • Raut VV, Bhat N, Sinnathuray AR, Kinsella JB, Stevenson M, Toner JG. Bipolar scissors versus cold dissection for pediatric tonsillectomy--a prospective, randomized pilot study. Int J Pediatr Otorhinolaryngol. 2002;64(1):9-15.

Comparison of four different techniques in pediatric tonsillectomy

Yıl 2022, Cilt: 8 Sayı: 1, 8 - 16, 23.04.2022
https://doi.org/10.30569/adiyamansaglik.1016868

Öz

Aim: In this study, we aimed to determine the appropriate tonsillectomy technique by comparing tonsillectomy methods in terms of duration of surgery, intraoperative bleeding, postoperative recovery time, and postoperative pain.
Materials and Methods: 160 pediatric patients who had tonsillectomy at Harran University Faculty of Medicine Department of Otolaryngology between January 1, 2017 and July 31, 2018 were included in this study.
Results: Patients were randomly divided into 4 groups based on the techniques used (cold dissection, bipolar cautery, coblation, and thermal welding). The surgery time, blood loss during surgery, and postoperative complications were recorded.
Conclusion: We found that the surgery time was shorter in the surgeries performed with thermal welding. Intraoperative hemorrhage, postoperative pain were lower in thermal welding technique. To return to normal diet and normal activity was determined as soon as possible in thermal welding method.

Kaynakça

  • Kearns DB, Pransky SM, Seid AB. Current concepts in pediatric adenotonsiller disease. Ear Nose Throat J 1991;70(1):15-9.
  • Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol.1987;13(2):149-56.
  • Brodsky L. Modern assesment of tonsils and adenoids. Ped Clin North Am. 1989;36(6): 1551-69.
  • Friedman M, Tanyeri H, La Rosa M, Landsberg R, Vaidyanathan K, Pieri S, Caldarelli D. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999;109(12):1901-7.
  • Wilson YL, Merer DM, Moscatello AL. Comparison of Three Common Tonsillectomy Techniques: A Prospective Randomized, Double-Blinded Clinical Study. Laryngoscope 2009:119(1):162-70.
  • Ozkiris M, Kapusuz Z, Saydam L. Comparison of three techniques in adult tonsillectomy. Eur Arch Otorhinolaryngol 2013; 270(3):1143–7.
  • Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, Rogers KD, Schwarzbach RH, Stool SE, Friday GA. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of paralel randomized and nonrandomized clinical trials. N Eng J Med 1984;310(11):674-83.
  • Cunningham LC, Chio EG. Comparison of out comes and cost in patients undergoing tonsillectomy with electrocautery and thermal welding. Am J Otolaryngol 2015;36(1):20-3.
  • Silveira H, Soares JS, Lima HA. Tonsillectomy: cold dissection versus bipolar electrodissection. Int J Pediatr Otorhinolaryngol 2003:67(4):345–51.
  • Ozkiriş M, Comparison of three techniques in pediatric tonsillectomy. Eur Arch Otorhinolaryngol 2012:269(5):1497–501.
  • Karatzias GT, Lachanas VA, MD, Sandris VG. Thermal welding versus bipolar tonsillectomy: A comparative study. Otolaryngology Head and Neck Surg 2006; 134(6): 975-8.
  • Omrani M, Barati B, Omidifar N, Okhovvat AR, Hashemi SAG. Coblation versus traditional tonsillectomy: A double blind randomized controlled trial J Res Med Sci. 2012; 17(1): 45–50.
  • Yilmaz M, Duzlu M, Catli T, Ustun S, Ceylan A. Thermal welding versus cold knife tonsillectomy: A prospective randomized study. Kaohsiung Journal of Medical Sciences. 2012; 28(5): 270-2.
  • Mann, D, St. George C, Scheiner E, Granoff D, Imber P, Mlynarczyk FA. Tonsillectomy—some like it hot. Laryngoscope.1984; 94(5):677–9.
  • Weimert TA, Babyak JW, Richter HJ. Electro dissection tonsillectomy. Arch Otolaryngol Head Neck Surg. 1990;116(2):186-8.
  • Subasi B. Tonsillektomi Sonrası Kanaması Olan Hastaların Değerlendirilmesi. Kafkas Journal of Medical Sciences. 2020:10 (3):228-232.
  • Timms MS, Temple RH. Coblation tonsillectomy: a double blind randomized controlled study. J Laryngol Otol.2002;116(6):450-2.
  • Stavroulaki P, Skoulakis C, Theos E, Kokalis N, Valagianis D. Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients. Ann Otol Rhinol Laryngol.2007;116(8):565-70.
  • Raut VV, Bhat N, Sinnathuray AR, Kinsella JB, Stevenson M, Toner JG. Bipolar scissors versus cold dissection for pediatric tonsillectomy--a prospective, randomized pilot study. Int J Pediatr Otorhinolaryngol. 2002;64(1):9-15.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Servet Erdemes 0000-0003-1296-0925

Alper Şen 0000-0003-0505-5214

Ahmet Yükkaldıran 0000-0002-1335-4110

Osman Erdoğan 0000-0001-9384-7881

Yayımlanma Tarihi 23 Nisan 2022
Gönderilme Tarihi 31 Ekim 2021
Kabul Tarihi 26 Ocak 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 8 Sayı: 1

Kaynak Göster

AMA Erdemes S, Şen A, Yükkaldıran A, Erdoğan O. Pediyatrik tonsillektomide dört farklı tekniğin karşılaştırılması. ADYÜ Sağlık Bilimleri Derg. Nisan 2022;8(1):8-16. doi:10.30569/adiyamansaglik.1016868