Comparison between bipolar diathermy and silk ligation technique during tonsillectomy

Abstract

Objective: to compare the use of bipolar diathermy and silk ligation in tonsillectomy with respect to operative time and post op hemorrhage, in our setting. Study design: randomized controlled trail. Place and duration of study: nishtar hospital, multan from May 2016 to May 2018.  Methodology: After consent, 234 patients of chronic tonsillitis of 5 to 35 year of age were selected as per inclusion and exclusion criteria. They were randomly divided in to two groups by using lottery method. In group A, tonsillectomy was done and suture ligation was applied for hemostasis. In group B, tonsillectomy was done and bipolar diathermy was used for hemostasis. Data was entered and analyzed by using SPSS software. Results: In our study, mean age was 13.84 + 5.83 years. Majority of patients 55.13% were between 5-15 years of age. Out of 234 patients, 71.37% were male and 28.63% were females. The mean operative time in group A was 29.45 + 9.71 minutes and in group B was 16.37 + 4.38 minutes with p-value <0.0001. Secondary hemorrhage was seen in 2.56% patients in group A (suture ligation group) and 10.56% patients in group B (Bipolar diathermy group) with p-value of 0.016. Conclusion: bipolar diathermy method of hemostasis in tonsillectomy is fast but associated with statistically increase risk of secondary hemorrhage compared to silk ligation.

Keywords: tonsillectomy, silk ligation, bipolar diathermy, operative interval, secondary hemorrhage.