Snare Method Research Articles

A Comparative Study Between Coblation-Assisted Tonsillectomy and Conventional Dissection and Snare Tonsillectomy.

Background Tonsillitis is a vastly prevalent disease, accounting for the majority of outpatient visits. The dissection and snare method has been the predominant approach for tonsillectomy for centuries. Coblation-assisted tonsillectomy offers advantages such as faster healing, shorter surgery duration, minimal blood loss, and fewer postoperative complications. Therefore, a study was conducted to evaluate the distinctions and compare the efficacy of traditional dissection and coblation-assisted tonsillectomy. Materials and methods Patients were divided into two groups: Group I was operated on using the conventional method, and Group II was operated on using the coblation method. Both groups were then assessed for intraoperative time, intraoperative bleeding, postoperative pain, and postoperative complications. Results Coblation-assisted tonsillectomy patients had a significantly shorter mean duration for the procedure and significantly lower blood loss in comparison to the conventional method. There were no statistically significant variations in the incidence of postoperative complications. Coblation-assisted tonsillectomy patients experienced considerably higher pain scores on various postoperative days. Conclusion Coblation-assisted tonsillectomy had the added advantage of reduced intraoperative blood loss, shorter surgical time, and faster recovery postoperatively. Coblation-assisted tonsillectomy can be considered an effective alternative to conventional methods. However, it's important to consider factors such as cost-effectiveness and surgeon experience. Further research involving larger sample sizes and longer follow-up periods could yield more insightful knowledge of the outcomes of these two tonsillectomy techniques.

Molecular Resonance Generator (MRG) Assisted Tonsillectomy - An Innovative Technique

Molecular Resonance Generator (MRG) Assisted Tonsillectomy - An Innovative Technique

Bleeding After Endoscopic Resection of Colonic Adenomatous Polyps Sized 4-10 mm.

Introduction: Colonoscopy with polypectomy is an efficacious procedure in reducing the risk of colorectal cancer development, the precursor are adenomatous polyps. The most common method for resection of polyps measuring 4-10 mm are cold (CSP) and hot snare polypectomy (HSP). CSP has a lower incidence of adverse events, especially delayed post-polypectomy bleeding. Aim: To evaluate the presence of immediate and delayed bleeding in the cold snare polypectomy of sub-centimeter polyps of the colon compared with hot snare polypectomy. Materials and Methods: This prospective clinical study is comprised all patients who were incidentally detected to have adenomatous colonic polyps measuring 4-10 mm during a colonoscopy screening. Polypectomy was done with (hot snare) or without electrocautery (cold snare). After removal of polyps, immediate bleeding, delayed bleeding, and methods for were analyzed. Results: The CSP and HSP groups included 116 patients, 113 (54.4%) polyps in 61 (52.6%) patients with CSP while 95 (45.6%) polyps in 55 (47.4%) patients with HSP. 25 (22.1%) polyps after CSP had immediate bleeding. In 5 patients (20.0%), five hemostatic clips were inserted after CSP for bleeding longer than 150 sek. The average percentage difference between immediate bleeding versus total number of resected polyps using the cold snare method is not statistically significant (p<0.05) (Difference test, p=0.0000). Delayed bleeding was not registered using this method. In the second investigated group (HSP), one patient had delayed bleeding. This was stopped with 2 clips. Immediate bleeding was not registered. Conclusion: CSP is safer than HSP in resecting colon polyps sized 4-10 mm, without risk of delayed bleeding.

Is Laser Better than Cold Steel (Dissection and Snare) for Tonsillectomy?

To analyse the surgical outcome of CO2 laser assisted tonsillectomy with the cold steel (conventional dissection and snare) tonsillectomy. This prospective, non-randomised, single blind study was conducted in 25 cases suffering with recurrent tonsillitis. The left tonsillectomy was performed with CO2 laser while the right tonsil was excised using cold steel method (conventional dissection and snare method). The surgical time, blood loss and post-operative pain for each method was recorded and analysed. CO2 laser tonsillectomy had highly significant less intra-operative blood loss (41.8ml vs. 78.8ml with p = 0.001) and postoperative pain levels on postoperative day 1,3, and 5 ( p value of 0.013, 0.006 and 0.000 respectively) as compared to cold steel method. However; there was no statistically significant difference in operative time between the two techniques (p > 0.05). CO2 laser tonsillectomy appeared to be better technique than cold steel in terms of intra-operative haemorrhage and pain.

A simple endoscopic treatment for large gastric bezoars: the guidewire and snare method.

A simple endoscopic treatment for large gastric bezoars: the guidewire and snare method.

QUALITY OF LIFE WITH CHRONIC TONSILLITIS IN ADULTS: A COMPARISON OF TONSILLECTOMY VERSUS CONSERVATIVE TREATMENT

Background: Chronic tonsillitis is a common pathology in Indian population. However, tonsillectomy is rarely preferred by adults owing to the anticipated post-operative pain and complications. Therefore, the benets of tonsillectomy in adults needs to be established. Aim:To evaluate the quality of life in adults with chronic tonsillitis undergoing tonsillectomy as compared to conservative treatment. Methodology:Atotal of 64 patients (n=44, tonsillectomy; n=20, conservative treatment) from 18-50 years were enrolled in a prospective cohort study. Patients with quinsy and malignancy of tonsils, sleep apnea were excluded. Tonsillectomy was performed by dissection and snare method. Patients were asked to ll a questionnaire, before and one year after the procedure in order to evaluate the impact of the procedure on their quality of life. Post-operative improvement in Quality of life (QoL) was assessed by Wilcoxon-sign rank test and proportion test using R studio (v 1.2.5001). Pvalue of ≤0.05 was considered signicant Results: Patients who underwent tonsillectomy had signicantly (P&lt;0.05) lower episodes of sore throat, fever and painful swallow after one year of the procedure, as compared to people undergoing conservative treatment. There was also a signicant reduction (P&lt;0.05) in the use of analgesics and antibiotics. Most patients (n=40) who underwent tonsillectomy were satised with the procedure and agreed that it had an overall positive impact of their lives. Conclusion: Tonsillectomy provides relief from the symptoms of tonsillitis thereby improving the Quality of Life in adults. It can thus be advised as a treatment of choice in adults with chronic tonsillitis

A Comparative Study of Conventional Tonsillectomy versus Coblation Tonsillectomy

BACKGROUND: Coblation tonsillectomy is a new surgical technique .This study compares coblation and traditional tonsillectomy techniques in view of their advantages and complication. AIM OF THE STUDY: To compare and study the advantages of conventional (Dissection and snare method) Tonsillectomy Versus Coblation Tonsillectomy with regards to Intraoperative Time, Intraoperative blood Loss, Post-Operative Pain and early return to normalcy. METHODOLOGY: Intraoperative Time, Intraoperative Blood Loss and Post-Operative Pain (visual analogue score), duration of hospital stay and complication. RESULTS: Peroperative time consumption and intra operative bleeding were very minimal with coblation method than with the conventional method. Post operative pain using symptomatic and visual analogue score were equal with the coblation and conventional method of tonsillectomy, but the average post operative pain by visual analogue score was lesser in coblation method, Coblation method was found to be SUPERIOR to conventional method using systemic criteria based prospective analysis. CONCLUSION: Compare to our Study Coablation will be useful in Adenoidectomy, Resection of tumors of larynx, hypo pharynx, oral cavity and oropharynx, Creating a cavity in a malignant lesion, Turbinectomy, Cost effectiveness, surgical skills, steep learning curve and microscopical settings were three main disadvantages with the coblation method. Coblation technique demands further research to be proven as a suitable and standard method.

Dissection and snare method of tonsillectomy, hemostasis by ligature technique in a tertiary care center: A decade study

Background: Despite advances in surgical technique, postoperative hemorrhage remains a common cause of morbidity and mortality for patients following tonsillectomy. Attempts to reduce the morbidity of tonsillectomy have included changes to the surgical techniques and perioperative medications to reduce the risk of bleeding. Here, we did a decade study about ligature technique in tonsillectomy for the achievement of hemostasis and its effectiveness in controlling morbidity. Aim: The aim of this study was to analyze the posttonsillectomy hemorrhage rate when we use ligature technique in tonsillectomy procedure. Materials and Methods: We retrospectively reviewed data of all patients who underwent tonsillectomy by dissection and snare method in the ENT Department, Chengalpattu Medical College and Hospital, Tamil Nadu, between March 1, 2010, and February 29, 2020. The rate of postoperative hemorrhage after using ligature technique was measured and compared with other methods used in other studies. Results: Totally 12,536 patients who underwent tonsillectomy were analyzed in this study. Posttonsillectomy hemorrhage occurred only in 62 patients (0.494%). Only 14 (0.001)) patients required re-intubation and correction procedure. The hemorrhage rate was very minimal when compared with other techniques in other studies. Conclusion: We conclude that the ligature technique used in tonsillectomy for hemostasis remains one of the best methods even though it is an ancient method.

Role of Pre-incisional Bupivacaine Infiltration in Post-tonsillectomy Analgesia.

Tonsillectomy is one of the common surgeries performed by Otorhinolaryngologists and is associated with several morbidities with pain being the commonest, which can cause considerable delay in oral intake and discharge from the hospital. As a commonly performed day care procedure nowadays, pain control is much better than what it used to be previously observed. Therefore newer drugs are being constantly studied inorder to give better analgesia and post operative comfort to the patient with minimal side effects. The main obstacle being finding the best medical method to control pain with minimum side effects, but at the same time making sure that the patient is adequately hydrated and they resume regular eating as soon as possible. Our aim is to study the role of pre-incisional 0.5% bupivacaine versus normal saline infiltration in post-tonsillectomy analgesia. Over a period of 1year, 30 patients with each group of 15 were compared for the efficacy of 0.5% bupivacaine and 0.9% normal saline in post-operative tonsillectomy pain management. After thorough clinical examination and investigations, all patients underwent tonsillectomy by dissection and snare method. After intubation, 0.5% bupivacaine or normal saline was infiltrated in the tonsillar fossa and pain scores was obtained using Visual Analogue Scale (V.A.S) at 6, 12 and 24h post operatively. Using Mann-Whitney non-parametric statistical test, inter-group analysis was done which showed highly significant p-value (<0.0001) indicating that the pre-incisional bupivacaine infiltration is highly effective in reducing the post-tonsillectomy pain. Hence, we recommend the routine use of pre-incisional peritonsillar infiltration of 0.5% bupivacaine in all tonsillectomy/adenotonsillectomy cases, irrespective of the age of the patient to reduce the post tonsillectomy pain and other discomfort associated with it.

Comparative Study of Pain Scale Assessment Between Cold Verses Hot Tonsillectomy Method.

Tonsillectomy is an age old surgery especially in pediatric population. Over the last few years, various techniques have been proposed in performing tonsillectomy in an attempt to lower the morbidity and mortality. This study compares the post-operative pain scale of cold dissection method and newer methods like coblation, radiofrequency and bipolar cautery assisted tonsillectomy. In our prospective study, we selected 30 patients and randomly divided them into three groups. We had performed right side tonsillectomy in each divided group of ten with coblation, radiofrequency and bipolar cautery assisted and on left side tonsillectomy dissection and snare method to all subjects. We compared post-operative pain scale on the right and left side in next consecutive 3 post-operative days by using VAS of Wong-Baker. Of these 30 patients mean age is 10 ± 3years and there is no significant sex distribution. In group 1 right side bipolar cautery (hot) method, pain scale was on 3 consecutive post-operative days (6.1 ± 1.5), (6.0 ± 1.5), (5.2 ± 0.9) when compared to left side cold method (p value 0.06). In group 2 right side coblation (hot) method, post-operative pain scale was (2.9 ± 1.6), (2.4 ± 1.6), (1.2 ± 1.4) which when compared to left side cold method showed that pain was significantly reduced (p value 0.03). In group 3 right side radiofrequency (hot) method post-operative pain scale was (4.6 ± 1.0), (2.5 ± 1.2), (1.5 ± 1.4) when compared to left side cold method pain (p value 0.08). This study revealed that coblation assisted hot tonsillectomy has less pain when compared to other techniques with normal cold method. It also has early recovery.

Comparison of tonsillectomy by coblation and tonsillectomy by conventional method

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Operations on tonsils and adenoids are performed since many years. Tonsillectomy produces an open wound that heals by secondary intention. Tonsillectomy is still a very common surgical procedure. There are various modalities to perform surgery (diathermy, laser, harmonic scalpel, radiofrequency cautery, cryosurgery and coblation). Among these, dissection and snare method are commonly done by ENT surgeons.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We carried out the prospective cross-sectional study to compare intraoperative blood loss, time taken for the surgery, post-operative pain score, degree of slough formation and complications between these two methods. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Average time for surgery on coblation side was less (15.1 min) than conventional side (36.04 min). For haemostasis on conventional side, all patients required bipolar cauterization while on coblation side only 8 patients (16%) required hemostasis. Average blood loss on coblation side (left) was 3.40ml while on conventional side (right) 25.57 ml. In my study, mean pain score on 1st day, 2&lt;sup&gt;nd&lt;/sup&gt; day, 5&lt;sup&gt;th&lt;/sup&gt; and 10&lt;sup&gt;th&lt;/sup&gt; day of surgery was 6.18, 4.10, 2.30 and 1.64 on conventional side and 4.36, 3.00, 1 and 0 on coblation side. In my study, only one patient had Secondary haemorrhage on conventional side on 7&lt;sup&gt;th&lt;/sup&gt; day.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The use of coblator reduces the time required for surgery, per-operative blood loss is very much less, chances of damage to surrounding structures are less, charring of tissue is less, post-operative severity of pain after 24 hours is very much less than that of dissection method. Slough formation was more on coblation side as compared to conventional side.&lt;/p&gt;

Hapsedilmiş Yan Dal Telinin Geri Çekilmesi Sırasında İmplante Edilmiş Stentin Yerinden Ayrılması: Sıradışı Bir Komplikasyon

Coronary stent dislodgement is a very rare complication during the percutaneous coronary intervention. It is associated with significant morbidity, systemic or coronary embolization, acute myocardial infarction, emergency coronary artery bypass surgery, vascular access complications, cerebrovascular complications and death. A deployed stent dislodgement is even more rare. We report an unusual complication of a deployed stent dislodgement during retrieval of stent jailed side branch guidewire and retrieval from popliteal artery via snare method. Stent dislodgements usually occur with undeployed stents while retraction of the stent into the guiding catheter .Risk factors for stent loss and dislodgement are severe calcification, tortuosity, failed stent retraction into the guiding catheter and failure to cross the lesion. Stent dislodgement can be treated either surgically or percutaneously

927 Traction-Assisted Endoscopic Submucosal Dissection Reduces Procedure Time and Risk of Adverse Events: A Meta-Analysis

INTRODUCTION: Endoscopic submucosal dissection (ESD) is superior to endoscopic mucosal resection (EMR) for treatment of superficial gastrointestinal neoplasia because it is associated with increased en bloc resection and lower rates of local recurrence. However, ESD is a technically demanding procedure with increased procedure time and has potential for serious adverse events. To overcome the procedural difficulty of ESD, Various traction methods such as clip-line method, clip and snare method and internal traction method, have been developed to provide countertraction to expose the dissection plane and allow safe and effective submucosal dissection. A number of studies have compared efficacy of traction-assisted ESD (T-ESD) and conventional ESD (C-ESD) but results are conflicting. We conducted a meta-analysis to assess the efficacy of T-ESD. METHODS: All clinical studies published up to April 2019 comparing the efficacy and safety of T-ESD and C-ESD were identified using electronic bibliographic searches of PubMed, Medline, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), and Web of Science (Science and Social Science Citation Index). Outcomes of interests included procedure time (minutes), rate of en bloc and R0 resections, and rates of adverse events (bleeding and perforation). Random effect model was used to calculate pooled mean difference (MD) for continuous variables and Odds ratios (ORs) for categorical variables. RESULTS: Of 621 articles identified, 18 studies [939 T-ESD and 963 C-ESD procedures] met inclusion criteria for final analysis [6 randomized controlled trials and 12 observational studies]. Overall, T-ESD significantly reduced procedure time (MD = - 16.63 min, 95% CI - 24.65 to - 8.60, P &lt; 0.0001, I 2 = 68) and complication rates (OR = 0.56, 95% CI 0.36 - 0.87, P = 0.009, I 2 = 0) compared to C-ESD. En bloc resection and R0 resection rates were similar in both groups (OR = 2.36; 95% CI 0.58 - 9.55; P = 0.23, I 2 = 0 and OR = 1.45; 95% CI 0.76 - 2.77; P = 0.25, I 2 = 0; respectively). No publication bias was detected by funnel plot. CONCLUSION: Traction techniques facilitate submucosal dissection, reduce procedure time and improve its safety. These techniques are simple and can be performed using readily available accessories in the endoscopy unit. Application of traction method improves feasibility of ESD and may enable the widespread use of ESD in the West.

Use of preoperative tranexamic acid in tonsillectomy with or without adenoidectomy to reduce primary haemorrhage

Background: Haemorrhage during adenotonsillectomy is a common and potentially grave complication especially in children due to less physiological compensation of total blood volume. Tranexamic acid being synthetic antifibrinolytic drug has been widely used in surgical procedures to reduce bleeding. Few researches have done to see its effectiveness during adenotonsillectomy. The objective of current study is to evaluate the use of preoperative tranexamic acid to reduce primary haemorrhage in children who undergo elective tonsillectomy with or without adenoidectomy. Subjects and methods: It was a It was a quantitative, randomized control study and conducted at Pakistan Railway hospital from June 2015 to September 2016.The current study included 80 children randomized into two groups. Children between the ages of 5 to 15 years had been operated for tonsillectomy with or without adenoidectomy. Group 1 (experimental group) was given tranexamic acid at a dose of 10mg/kg of body weight intravenously, 30 minutes before induction of anaesthesia while the other arm (control arm) did not receive injection tranexamic acid. All children underwent dissection and snare method under general anaesthesia. P-value were obtained by applying independent sample t-test and considered statistically significant at 0.05 in reduction of primary haemorrhage during the procedure. Results: In study group mean amount of primary haemorrhage was 64.56 (+40.85) ml and in control group was 98.34 (+62.57) ml. The comparison of Boezzart blood grading scale was also significantly different between both groups. Conclusion: Preoperative tranexamic acid when used intravenously is effective in reducing primary haemorrhage during tonsillectomy with or without adenoidectomy.

Comparison of post-tonsillectomy morbidity operated with Cold Knife and Coblation in patients with Sleep Apnea

Objective: To compare post-tonsillectomy morbidity between the Snare and Coblation methods in patients with sleep apnea. Method: The study is performed in 49 cases. Twentyone patients who were operated by Snare method while the other 28 patients underwent coblation tonsillectomy. The amount of intraoperative bleeding has been recorded. The pain levels at the postoperative hours 6th and 12th.; on the postoperative days of 1, 3, 7 the patients were assessed through VAS and Wong-Baker-Faces-Pain-Rating-Scale (WBFPRS) and were compared between two groups. The Tonsillar-Fossa-Wound-Healing-Score (TFWHS) assessment was carried out for the wound healing rate on the postoperative days of 1, 3, 5, 7 and 10. Results: The patients who underwent coblation had significantly lower amounts of bleeding compared to the snare method (p=0.046). The patients who were assessed within the scope of this study and underwent tonsillectomy with snare method had significantly higher 6th hour VAS and WBFPRS scores (p=0.011, p=0.005); whereas 12th hour, days of 1, 2, 3 and 7 VAS and WBFPRS scores were similar. TFWHSs of the studied patients who underwent coblation were significantly higher on the days of 1 and 3 (p=0.007; p=0.008) but these scores were similar on days of 5, 7, and 10. Conclusion: The study has showed that the amount of intraoperative bleeding of the cases underwent coblation is significantly lower. The lower early period postoperative pain resulting in earlier oral intake and better recovery scores for the tonsillary fossa seems to be the advantages of the coblation as opposed to the snare method.

Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group.

IntroductionTonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children.Materials and methodsChildren under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination.ResultsA total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, β-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens.ConclusionPolymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.

Tonsillectomy by Cold Dissection and Coblation Techniques: A Prospective Comparative Study

Inflammatory and infectious diseases of tonsils are common in paediatric and adult otolaryngological practice and ensue in tonsillectomy which is a common surgical procedure. Dissection and snare method is being performed for ages and has evolved over a period of time while coblation is a newer technique started in 1997. It combines radiofrequency energy and normal saline, resulting in a plasma field of highly ionized particles which dissociates intercellular bonds and thus melts tissue at low temperatures (40-70°C) thereby reducing tissue damage. To compare the intraoperative time, intraoperative blood loss, post operative pain and post operative blood loss between dissection tonsillectomy and coblation tonsillectomy. This study was carried out at the outpatient Department of Otorhinolaryngology and Head and Neck Surgery in Meenakshi Medical College, Hospital and Research Institute, Tamil Nadu. Patients with chronic and recurrent tonsillitis who were planned electively for tonsillectomy were included in this study. Study was based on the analysis of 60 patients aged between 5 and 40years. All these 60 patients were thoroughly investigated by doing a complete surgical workup. They all were subjected to 2 different tonsillectomy procedures-dissection and snare method and coblation technique. Patients were assigned into two groups of 30 each by simple random sampling. Among these 60 patients, blood loss and post operative pain was less in Group 2 (coblation) and the duration of surgery was less in Group 1 (dissection and snare). In this study, patients who underwent surgery in Group 2 (coblation) showed better outcome when compared to Group 1 (dissection and snare method).

The effect of using pre-operative ketamine injection on post-tonsillectomy pain intensity in children

Introduction: Tonsillectomy in children is associated with some major complications originating from intense post-tonsillectomy pain which can distress patients, cause swallowing difficulties and discomfort, and also lead to aspiration. Thus, this study aimed to investigate the effect of using pre-operative ketamine injection on post-tonsillectomy pain intensity in children.&#x0D; Methods: This double-blind clinical trial was carried out on 60 patients undergoing elective tonsillectomy. To this end, all the patients were anaesthetized by the same method. In the first group, 2 cc of ketamine (0.5mg/kg) solution was topically injected into the soft tissue of tonsillar fossa (peritonsillar space); in the second group, a similar administration was performed but with normal saline. For all the patients, incision was made 5 minutes after injection with the Blast Dissection Snare method. Moreover, the patients’ pain intensity and analgesics consumption were measured 30 minutes, and 1, 2, 4, and 6 hours after surgery. Finally, the collected data were analyzed using the SPSS software.&#x0D; Results: The present study was conducted on 60 patients, 37 males and 23 females, with the mean age of 9.3±3.4 years. In this respect, repeated measures analysis of variance of patients’ pain scores collected in five post-operative stages showed that pain intensity in both groups was at the highest level immediately after operation; it gradually decreased during measurement stages. However, at each measurement, the pain intensity experienced in the ketamine-treated group was significantly lower than that for the placebo group.&#x0D; Conclusion: It was concluded that pre-incision topical injection of ketamine can serve as an effective method to control post-tonsillectomy throat pain.

Cold snare resection for the treatment of benign airway lesions.

The objective was to assess the safety and outcome of cold snare technique used by flexible bronchoscopy in the treatment of airway benign neoplasms. The clinical data of 21 patients, who had airway benign neoplasm and were treated through the cold snare method in Sir Run Run Shaw Hospital, affiliated with the Zhejiang University, were retrospectively analyzed. The relief of the symptoms and occurrence of complications were observed and evaluated. All the tumors were benign and removed by cold snare. Postoperatively, we found that the treatment was completely effective in 12 patients, and there was a significant improvement in 7 patients and a moderate improvement in 2 patients, and no recurrence in follow-up visit. In conclusion, the cold snare technique is an economically feasible, safe, and effective method in the treatment of airway neoplasms.

Impact of the clip and snare method using the prelooping technique for colorectal endoscopic submucosal dissection.

Endoscopic submucosal dissection (ESD) is more difficult to perform for colorectal tumors, but the use of traction to facilitate direct submucosal layer visualization is a promising method to reduce procedure times and complication rates. This study aimed to evaluate the efficacy and safety of the clip and snare method (CSM) with a prelooping technique (PLT) for colorectal tumors. A total of 140 colorectal tumors were treated: 17 using the CSM with PLT; 123, used as controls, by standard ESD without these techniques. Therapeutic efficacy and safety were retrospectively assessed. All tumors were successfully resected en bloc using the CSM with PLT. Multisegment resection was found in four tumors in the control group. There was a significant difference in the procedure time between the patients in the CSM with PLT group and the control group (45.6 vs. 70.1 minutes; P = 0.047). There were no significant differences in the complication rates (5.9 % vs. 8.1 %; P = 1.00). The CSM with PLT was effective and safe in this study.