24 A STUDY OF COMPARISON BETWEEN SILK LIGATION AND BIPOLAR CAUTERY IN TONSILLECTOMY
Journal Title: Indian journal of applied basic medical sciences - Year 2018, Vol 20, Issue 31
Abstract
Background: Tonsillectomy is one of the most commonly performed surgical procedure. Different techniques and instruments have been used for removal of tonsils along with haemostasis but none of them were found satisfactory. The aim of this study is to assess and compare the relative efficacy of silk ligation and bipolar cautery coagulation techniques in controlling bleeding during tonsillectomy. Materials and Methods : This prospective study was conducted at the department of ENT, M.P.Shah Government Medical College, Jamnagar. The study included 70 cases. All patients included were having history of recurrent, chronic tonsillitis, with more than 6-7 episodes in one year, 5 episodes in year for 2 years, or 3 episodes per year for three years. All surgeries were performed by conventional (dissection) method leaving behind the capsule intact. Results of the two groups i.e. tonsillectomy using silk ligation or bipolar cautery for haemostasis was studied. Results: Tonsillectomy of 70 patients was performed; 39(55.71%) male and 31(44.29%) female. Bipolar cautery was used in 35 patients to achieve haemostasis while silk ligation in 35. The age of ranged from 3 to 30 years and above with the mean age of 23.33 years. Analgesia requirement in first 24 hours were equal in both groups. Incidence of primary haemorrhage was noticed in 6(17.14%) cases when haemostasis was achieved with use of silk ligation and in 2(5.71%) cases when bipolar cautery used( due to loosening of knot and rise of blood pressure after the effect of anaesthesia wears off and due to post-operative reactionary oedema). Incidence of secondary haemorrhage was nil after tonsillectomy with use of both bipolar cautery and silk ligation. In our study, bipolar cautery was better than silk ligation in post-operative haemorrhage. Conclusion: chances of secondary haemorrhage were equal but primary haemorrhage was significantly less in bipolar cautery.
Authors and Affiliations
DR. NEHAL R. PATEL
Keywords
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