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Coblation tonsillectomy in children: Incidence of bleeding

Authors

  • David L. Walner MD,

    Corresponding author
    1. Department of Otolaryngology, Rush University Medical Center, Chicago, Illinois, U.S.A.
    2. Division of Otolaryngology, Lutheran General Hospital and Lutheran General Children's Hospital, Park Ridge, Illinois, U.S.A.
    • 1653 W. Congress Parkway, Chicago, IL 60612
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  • Steven P. Miller BS,

    1. Division of Otolaryngology, Lutheran General Hospital and Lutheran General Children's Hospital, Park Ridge, Illinois, U.S.A.
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  • Dana Villines MA,

    1. Division of Research, Lutheran General Hospital and Lutheran General Children's Hospital, Park Ridge, Illinois, U.S.A.
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  • Gregory S. Bussell MD

    1. Division of Otolaryngology, Lutheran General Hospital and Lutheran General Children's Hospital, Park Ridge, Illinois, U.S.A.
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the intraoperative and postoperative bleeding rate utilizing the Coblation device for total tonsillectomy in children.

Study Design:

Prospectively designed clinical study.

Methods:

Institutional review board approval was obtained to study patients undergoing Coblation tonsillectomy. Records of all children 1 to 18 years of age undergoing tonsillectomy or adenotonsillectomy from April 2003 to April 2010 were reviewed. All children underwent total tonsillectomy utilizing the Coblation device, and the intraoperative and postoperative bleeding complications were analyzed. The data were also analyzed to determine whether surgeon experience with the technique influenced the bleeding rate.

Results:

A total of 1,918 patients were evaluated. Intraoperative blood loss was <5 mL in >90% of the patients, with no patients experiencing >20 mL of blood loss. The postoperative bleeding rate was consistent with the literature (n = 87, 4.5%). Of the patients with bleeding following surgery, five (5.7%) experienced primary bleeding and 82 (94.3%) secondary bleeding. Postoperative bleeding that ceased spontaneously and did not require intervention was present in 56 (2.9%). The number of patients who actually required intervention to control postoperative bleeding was 31 (1.6%). The majority of bleeding occurred by postoperative day 7. There was no statistically significant difference in bleeding rates by age, and there was no evidence found to support a surgeon learning curve for performing Coblation tonsillectomy.

Conclusions:

This study provides further support that Coblation total tonsillectomy in children is a reliable and safe procedure with a relatively low incidence of intraoperative and postoperative bleeding.

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