Post-operative bleeding is less after partial intracapsular tonsillectomy than bipolar total procedure

Abstract

Objective To compare bleeding after partial intracapsular tonsillectomy (PIT) and bipolar diathermy tonsillectomy (BDT). Design Retrospective chart review. Setting Stollery Children's Hospital, tertiary pediatric referral centre. Patients All children (≤17 years of age) who had tonsillectomy. Patients who had incomplete information or less than 2-weeks follow-up were excluded. Main outcome measure (1) Post-tonsillectomy bleeding, (2) other data collected included demographics, length of follow-up, indication(s) for surgery, other procedures performed, and co-morbidities. Results Over a 4.5-year period 677 patients (333 BDT, 344 PIT) were identified in our search, and 77 (38 BDT, 39 PIT) were excluded. The mean age was 7.7 ± 3.8 years in the BDT group and 6.5 ± 3.2 years in the PIT group. Sex distribution was similar in the 2 groups (chi square p = 0.61). Twenty (6.8%) BDT patients experienced post-tonsillectomy bleeding, compared to three (0.98%) of PIT patients ( p = 0.0001, 95% CI 1.52–2.18, OR = 7.32). Over 3 times as many PIT patients (153) had co-morbid conditions than BDT patients (44); this was statistically significant (chi square p < 0.00001, 95% CI 1.78–2.38). Conclusion PIT results in significantly less post-tonsillectomy bleeding than BDT. These findings favor partial over total techniques with respect to reducing this important complication.