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Microdebrider tonsillectomy associated with more intraoperative blood loss than electrocautery
Journal article   Peer reviewed

Microdebrider tonsillectomy associated with more intraoperative blood loss than electrocautery

Kyle J. Stansifer, Molly G. Szramowski, Lindsay Barazsu and Farrel J. Buchinsky
International journal of pediatric otorhinolaryngology, v 76(10), pp 1437-1441
01 Oct 2012
DOI: https://doi.org/10.1016/j.ijporl.2012.06.018
PMID: 22796194
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Life Sciences & Biomedicine Otorhinolaryngology Pediatrics Science & Technology
Objective: To describe and compare the intraoperative blood loss in children who underwent tonsillectomy and/or adenoidectomy during a transition from using electrocautery to a microdebrider. Methods: Retrospective case series of a single pediatric otolaryngologist at an urban general hospital. Patients aged 2-20 years who had tonsillectomy, adenoidectomy, or adenotonsillectomy over a 12 month period were included. Tonsillectomy was performed by microdebrider or electrocautery and adenoidectomy was performed by microdebrider, curette, or suction electrocautery. Total intraoperative blood loss was measured and compared between surgical techniques. Results: Of the 148 patients, 109 had tonsillectomy with or without adenoidectomy and 39 had adenoidectomy alone. The mean blood loss was 47 ml or 1.8 +/- 1.6 ml/kg and the maximum blood loss was 11 ml/kg. Adenoid curette and adenoid microdebrider yielded similar blood loss but were associated with more bleeding than suction electrocautery (P < 0.05). Microdebrider tonsillectomy yielded more blood loss than electrocautery tonsillectomy (mean of 2.6 +/- 2.2 ml/kg versus 1.2 +/- 1.2 ml/kg, P = 0.0002). Eighteen percent of adenotonsillectomy patients lost greater than 5% of calculated circulating blood volume (95% Cl, 9.8-26). Linear regression models did not show an association between the amount of blood loss and patient age, clinical indication, or the surgeon's experience with the microdebrider (P > 0.05). Conclusions: Microdebrider tonsillectomy is associated with more intraoperative bleeding than electrocautery tonsillectomy. Approximately twice as much blood was lost with the microdebrider, but the absolute increase was insignificant from a hemodynamic perspective. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

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Collaboration types
Domestic collaboration
Web of Science research areas
Otorhinolaryngology
Pediatrics
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