Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?

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Aim: Tonsillectomy is one of the most common surgical procedures in the pediatric population, as well as one of the first operations learned during otolaryngology residency. This study aims to evaluate the effect of surgical technique on the occurrence of post-tonsillectomy hemorrhage.Material and Methods: This prospectively-designed clinical trial was conducted in a tertiary referral center between May 2012 and April 2015. A total of 608 patients had tonsillectomies performed by a single surgeon with three different surgical techniques used during the study period. Patients in group one were operated on using cold dissection; group two comprised patients who underwent bipolar cautery; group three had the posterior pillar mucosal suturing technique performed.Results: 608 patients met inclusion criteria; 165 of them in group one, 274 in group two, and 169 in group three. The median age was 5 (2-14) years old. A total of five patients (0.82%) experienced post-operative bleeding. One of these patients (from group one) experienced primary hemorrhage. The four others were considered secondary hemorrhage; two from each the bipolar cautery and posterior pillar mucosal suturing groups. The rates of post-operative hemorrhage in each group were 0.61%, 0.73% and 1.18%, respectively (p=0.861). Only one of the five patients necessitated a return to the operating room to control the bleeding.Conclusion: Our study findings suggest that the choice of surgical technique does not affect the post-tonsillectomy bleeding rate. There were no significant differences in bleeding rates between subgroups.

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