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Çocuklarda postoperatif kanama ve ağrı açısından bipolar koter ve harmonik bıçak tonsillektominin karşılaştırılması

Yıl 2020, , 41 - 46, 23.04.2020
https://doi.org/10.30569/adiyamansaglik.629246

Öz

Amaç: Çocuklarda bipolar koter ile harmonik bıçak tonsillektomiyi postoperatif kanama ve ağrı açısından karşılaştırmak.
Gereç ve Yöntem: Grup A'daki 25 hastaya bipolar koterle ve grup B'deki 25 hastaya harmonik bıçakla tonsillektomi yapıldı. Postoperatif kanama ve ağrı açısından sonuçları değerlendirildi. Hastaların ağrılarının değerlendirilmesi görsel analog skala ile yapıldı.
Bulgular: Postoperatif kanama her grupta birer hastada meydana geldi. Postoperatif 1. gün ortalama ağrı bipolar tonsillektomi grubunda (BTG) 8.51±1.31, harmonik bıçak grubunda (HBG) 6.02±0.84, 3. gün BTG’de 6.84±1.42, HBG’de 4.98±1.03 ve postoperatif 5. günde BTG’de 5.39±0.73, HBG’de 3.95±0.74 idi ve bu farklar istatistiksel olarak anlamlıydı (p<0.05). Postoperatif 7. günün ağrı skorları incelendiğinde BTG’de 4.23±0.87, HBG’de 3.63±0.61, 10. günde BTG’de 3.21±0.92 ve 2.84±0.59 HBG’de ise bu farklar istatistiksel olarak anlamlı değildi (p>0.05).
Sonuç: Harmonik bıçak tonsillektomi tekniği erken postoperatif dönemde bipolar koter tekniğine kıyasla anlamlı derecede daha az ağrılıdır.

Kaynakça

  • 1. Potts KL, Augenstein A, Goldman JL. A parallel group analysis of tonsillectomy using the harmonic scalpel vs electrocautery. Arch Otolaryngol Head Neck Surg 2005;131:49-51.
  • 2. Andrea M. Microsurgical bipolar cautery tonsillectomy. Laryngoscope 1993;103:1177-1178.
  • 3. Amaral JF. experimental development of an ultrasonically activated scalpel for laparoscopic use. Surg Laparosc Endosc 1994;4:92-99.
  • 4. Hayashi A, Takamori S, Matsuo T, Tayama K, Mitsuoka M, Shirouzu K. Experimental and clinical evaluation of the harmonic scalpel in thoracic surgery. Kurume Med J 1999;46:25-29.
  • 5. Tosun F, Karapınar U. Complıcations of tonsillectomy and adenoidectomy. Turkiye Klinikleri J Surg Med Sci 2005;1:26-29.
  • 6. Kristensen S, Tveteras K. Post-tonsillectomy haemorrhage: a retrospective study of 1150 operations. Clin Otolaryngol 1984;9:347-350.
  • 7. Rasmussen N. Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin North Am 1987;20: 383-390.
  • 8. Conley SF, Ellison MD. Avoidance of primary posttonsillectomy hemorrhage in a teaching program. Arch Otolaryngol Head Neck Surg 1999; 125: 330-333.
  • 9. Leaper M, Mahadevan M, Vokes D, Sandow D, Anderson BJ, West T. A prospective randomised single blinded study comparing harmonic scalpel tonsillectomy with bipolar tonsillectomy. Int J Pediatr Otorhinolaryngol 2006;70:1389-1396.
  • 10. Roth JA, Pincock T, Sacks R et al. Harmonic scal-pel tonsillectomy versus monopolar diather-my tonsillectomy: a prospective study. Ear Nose Throat J. 2008;87(6):346-349.
  • 11. Polites N, Joniau S, Wabnitz D et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial.ANZ J Surg. 2006;76(4):226-229.
  • 12. Sayin I, Cingi C. Recent medical devices for tonsillectomy. Hippokratia 2012;16:11-16.
  • 13. Kemal O. Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial. Eur Arch Otorhinolaryngol 2012;269:1533-1536.
  • 14. Ali NS, Ikram M, Akhtar S, Moghira I, Nawaz A, Arain A. Harmonic scalpel versus elevtrocautery tonsillectomy: a comparitive studdy in adult patients J Pak Med Assoc. 2011;61(3):256-9.

Comparison of bipolar cautery dissection and harmonic scalpel tonsillectomy in terms of postoperative bleeding and pain in children

Yıl 2020, , 41 - 46, 23.04.2020
https://doi.org/10.30569/adiyamansaglik.629246

Öz

Aim: To compare postoperative bleeding and pain in children after tonsillectomy with bipolar diathermy versus tonsillectomy with harmonic scalpel tonsillectomy.
Materias and Methods: Group A, 25 patients were treated by tonsillectomy with bipolar diathermy and group B, 25 patients underwent tonsillectomy with harmonic scalpel. 
Results: Postoperative bleeding occurred in one patient in each group. The mean pain postoperative first day was 8.51±1.31 in the bipolar tonsillectomy group (BTG) and 6.02±0.84 in the harmonic scalpel group (HSG), 3th day 6.84±1.42 in the BTG and 4.98±1.03 in the HSG and at the postoperative 5th day were examined, it was 5.39±0.73 in the BTG and 3.95±0.74 in the HSG and this differences were significant statistically (p<0.05).
Conclusion: Harmonic scalpel tonsillectomy technique is significantly less painful in postoperative early period compared to bipolar cautery technique.

Kaynakça

  • 1. Potts KL, Augenstein A, Goldman JL. A parallel group analysis of tonsillectomy using the harmonic scalpel vs electrocautery. Arch Otolaryngol Head Neck Surg 2005;131:49-51.
  • 2. Andrea M. Microsurgical bipolar cautery tonsillectomy. Laryngoscope 1993;103:1177-1178.
  • 3. Amaral JF. experimental development of an ultrasonically activated scalpel for laparoscopic use. Surg Laparosc Endosc 1994;4:92-99.
  • 4. Hayashi A, Takamori S, Matsuo T, Tayama K, Mitsuoka M, Shirouzu K. Experimental and clinical evaluation of the harmonic scalpel in thoracic surgery. Kurume Med J 1999;46:25-29.
  • 5. Tosun F, Karapınar U. Complıcations of tonsillectomy and adenoidectomy. Turkiye Klinikleri J Surg Med Sci 2005;1:26-29.
  • 6. Kristensen S, Tveteras K. Post-tonsillectomy haemorrhage: a retrospective study of 1150 operations. Clin Otolaryngol 1984;9:347-350.
  • 7. Rasmussen N. Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin North Am 1987;20: 383-390.
  • 8. Conley SF, Ellison MD. Avoidance of primary posttonsillectomy hemorrhage in a teaching program. Arch Otolaryngol Head Neck Surg 1999; 125: 330-333.
  • 9. Leaper M, Mahadevan M, Vokes D, Sandow D, Anderson BJ, West T. A prospective randomised single blinded study comparing harmonic scalpel tonsillectomy with bipolar tonsillectomy. Int J Pediatr Otorhinolaryngol 2006;70:1389-1396.
  • 10. Roth JA, Pincock T, Sacks R et al. Harmonic scal-pel tonsillectomy versus monopolar diather-my tonsillectomy: a prospective study. Ear Nose Throat J. 2008;87(6):346-349.
  • 11. Polites N, Joniau S, Wabnitz D et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial.ANZ J Surg. 2006;76(4):226-229.
  • 12. Sayin I, Cingi C. Recent medical devices for tonsillectomy. Hippokratia 2012;16:11-16.
  • 13. Kemal O. Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial. Eur Arch Otorhinolaryngol 2012;269:1533-1536.
  • 14. Ali NS, Ikram M, Akhtar S, Moghira I, Nawaz A, Arain A. Harmonic scalpel versus elevtrocautery tonsillectomy: a comparitive studdy in adult patients J Pak Med Assoc. 2011;61(3):256-9.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Mehmet Erkan Kaplama 0000-0003-4662-409X

Yayımlanma Tarihi 23 Nisan 2020
Gönderilme Tarihi 4 Ekim 2019
Kabul Tarihi 17 Mart 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Kaplama ME. Comparison of bipolar cautery dissection and harmonic scalpel tonsillectomy in terms of postoperative bleeding and pain in children. ADYÜ Sağlık Bilimleri Derg. Nisan 2020;6(1):41-46. doi:10.30569/adiyamansaglik.629246