Abstract
The plasma blade is an innovative device that was recently introduced for performing tonsillectomy. While one of the benefits of the plasma blade is limited thermal damage, the effects of plasma blades on postoperative hemorrhage have not been thoroughly investigated. Patients who underwent tonsillectomy in our institution between January 2013 and September 2018 were retrospectively enrolled in the study. A total of 1214 patients were enrolled in the study, with 759 participants who underwent monopolar tonsillectomy and 455 participants who underwent plasma blade tonsillectomy. In total, 14 bleeding events occurred in the monopolar group, and 10 events occurred in the plasma blade group. The odds ratio for postoperative bleeding in the plasma blade group was 1.20 (95% CI 0.52 to 2.72). After adjusting for potential confounders, the adjusted odds ratio was 1.34 (95% CI 0.58 to 3.07). In conclusion, there is no significant difference in post-tonsillectomy hemorrhage rates between the traditional monopolar technique and plasma blade technique. Plasma blade tonsillectomy can be considered as safe as traditional monopolar tonsillectomy.
Highlights
Tonsillectomy is one of the most common procedures performed by otolaryngologists worldwide
There is no significant difference in post-tonsillectomy hemorrhage rates between the traditional monopolar technique and plasma blade technique
Between 1 January 2013 and 30 September 2018, 1979 cases of tonsillectomy and uvulopalatopharyngoplasty were performed in the institution. 511 patients who underwent uvulopalatopharyngoplasty without tonsillectomy and 254 patients who underwent adenoidectomy only were excluded from the study
Summary
Tonsillectomy is one of the most common procedures performed by otolaryngologists worldwide. Most tonsillectomies are performed without complications, current studies demonstrate a 2% to 5% risk of post-tonsillectomy bleeding [2,3] in patients with normal coagulation function. Life-threatening complications might occur due to post-tonsillectomy hemorrhages [4]. Numerous alternative devices have recently been introduced for tonsillectomy, including the coblation [5], microdebrider [6], Ligasure [7], and harmonic scalpel [8] devices. Several studies have pointed out that these modern devices may lower postoperative pain [5,6,7,8] and reduce operating time [7]. The PEAK plasma blade is a new device that uses radiofrequency energy to perform cuts and coagulation. Less thermal damage may lead to less tissue damage [9], decreased postoperative pain, and faster scar healing [9]
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