DOI: 10.36347/sjams.2024.v12i05.008

Pages: 548-555

Objectives: To assess whether bipolar electro dissection tonsillectomy has better surgical outcome compared to traditional cold steel dissection followed by silk ligature. Methodology: A Randomized Control Trial (RCT) was conducted at Department of ENT and Head-Neck surgery, Dhaka Medical College Hospital, from 1st January, 2020 to 30th July, 2021 Total 100 patients were enrolled through non- probability consecutive sampling and according to the selection criteria, who were admitted for elective tonsillectomy. They were randomly allocated into two groups of 50 persons each Bipolar electro dissection' (BED) and 'Cold Steel Dissection (CSD) group according to surgical method applied on them. The parameters of comparison were-duration of surgical technique, intraoperative blood loss, post-operative hemorrhage, pain, time taken returning to solid diet and healing rate of tonsillar fossac. Results: The mean operative time was 23.7±4.4 minutes in BED whereas 47.2±48.1 minutes in CSD method (p<0.0001). Mean intra operative blood loss was less in BED (16.4±6.6ml) than in CSD (37.8±6.6ml) technique (p<0.001). Overall reactionary hemorrhage rate was 12% and overall secondary hemorrhage rate was 18%. There was no statistically significant difference in post-operative hemorrhage incidence between two methods (p=0.373). Moderate to severe post- operative pain is more common bipolar method (68% & 12%) than dissection method (46% & 6%) which was significant (p=0.012). Mean time taken to return to solid diet for BED group was 8.12 days (range 3-16 days) and for the CSD group was 4.23 days (range 3-15 days) (p>0.05). Regarding aspect of the tonsillar fossa in the CSD group healing was faster than BED group (p>0.05). Conclusion: Operative time and intraoperative blood loss was significantly less in the bipolar electro dissection tonsillectomy (BED) group. Postoperative pain was significantly less in cold steel dissection tonsillectomy (CSD) group. Time taken to return to solid ......