Trans-septal Suturing Technique Research Articles

İki Farklı Nazal Tampon Materyali ile Transseptal Sütür Tekniğinin Karşılaştırılması

İki Farklı Nazal Tampon Materyali ile Transseptal Sütür Tekniğinin Karşılaştırılması

Comparison of nasal packs with transseptal suturing after nasal septal surgery

ObjectivesTo investigate the effects of transseptal suturing against two different types of nasal packs with respect to pain, operative time and postoperative complications following nasal septal surgery. Patients and methodsOne hundred and fifty patients (aged 18–61years) scheduled for nasal septal surgery were included. Following surgery, three types of nasal packing systems were utilized: (1) transseptal suturing (Group A: 50 patients); (2) internal nasal splint (Group B: 50 patients); (3) a Merocel standard 8-cm nasal dressing without airway (Group C: 50 patients) to the patients. Postoperative pain, operation time, septal perforation and synechiae formation were evaluated. ResultsThe difference between mean operative time of groups B and C was not statistically significant (p>0.05). The difference between operative time of the two groups against group A was statistically significant (p<0.05). The mean postoperative pain scores were 2.8±1.2 (median 2) in group A, 6.1±1.3 (median 6) in group B, and 7.3±1.2 (median 7) in group C 1h to 48h post-surgery. Merocel and internal nasal splint tampons were found to be significantly more painful than transseptal suturing during 48h (p<0.05). There was no statistically significant difference in terms of infection, hematoma, synechiae formation or perforation between the groups (p>0.05). ConclusionThe use of transseptal suturing technique is a useful alternative to packing, with only minor increase in operating time.

Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis.

Trans-septal suturing techniques are routinely used to obviate the need for packing after septoplasty surgery. This study aimed to systematically assess the evidence for the efficacy and safety of suturing techniques after septoplasty. A MEDLINE, Scopus, Cochrane Library, and ProQuest Dissertations & Thesis Database search, followed by extensive hand-searching for the identification of relevant studies. No time and language limitations were applied. Only prospective randomized controlled trials (RCTs) comparing trans-septal suturing techniques following septoplasty with conventional packing were included. For each outcome, risk difference and 95% confidence intervals (CIs) were calculated. Tests for heterogeneity and tests for publication bias were applied. Eight RCTs with 869 patients were included in the review. Postoperative pain and headache were significantly lower in the non-packing group. Conventional packing and trans-septal suturing technique appear to be equivalent with regard to postoperative haemorrhage risk, mucosal adhesions, septal perforation, septal haematoma and local infection. The evidence for the advantage of suturing techniques over conventional packing in septoplasty is now robust, and the use of suturing techniques as a first line intervention is becoming advisable.