Bipolar scissors versus cold dissection tonsillectomy: A prospective, randomized, multi-unit study

Objective: To evaluate bipolar scissors tonsillectomy by comparing it with traditional cold dissection tonsillectomy. Study Design: A prospective, ran domized, multi-unit study. Settings: Belfast City Hospital, Royal Victoria Hospital Belfast, and Ulster Hospital Dundonald. Patients: Two hundred cons ecutive patients undergoing tonsillectomy for recurrent or chronic tonsilli tis between March 2000 and September 2000. Outcome Measures: (1) Intraopera tive bleeding, (2) operative time, (3) postoperative pain, and (4) complica tion rates, including primary and secondary hemorrhage. Results: Seventeen patients were excluded from the study for various reasons. The mean age of the study population was 22 years (range, 10-54 y). Seventy-two percent of patients were female. Twenty-seven percent of patients were children aged 1 6 years or under. Median intraoperative blood loss was 5 mL for bipolar sci ssors tonsillectomy and 115 mL for cold dissection tonsillectomy (P < .001) . The mean operative time was 13 minutes for bipolar scissors tonsillectomy compared with 20 minutes for the cold dissection method (P < .001). There was no statistically significant difference in the pain scores between the two methods (independent samples t = 1.35; P > .05). The overall primary he morrhage rate was 2.1%, whereas the overall secondary hemorrhage rate was 1 6.9%. The hospital readmission rate was 10.3%. The primary and secondary he morrhage rates were unaffected by the surgical method. Conclusions: Bipolar scissors tonsillectomy is a safe technique with a similar morbidity to the cold dissection method. Its use is associated with a significant decrease in both surgical time and blood loss compared with the cold dissection meth od.