Efficacy and adverse effects of vessel sealing system tonsillectomy vs cold knief tosillectomy : a randomized, control study

Abstract

Objective: To compare efficacy and adverse effects between vessel sealing system tonsillectomy (VSST) and cold knife tonsillectomy (CKT). Study design: randomized, paired-control study Setting: Department of Otolaryngology, King Chulalongkorn Memorial Hospital Research methodology: Twenty three subjects were enrolled. Intervention was randomized and performed by VSST on one side of tonsil and CKT on the other side. Measured outcomes intraoperative blood loss, operative time, postoperative pain scale (FPS-R), postoperative bleeding and other adverse effects assessed daily by blinded assessors until postoperative day 14. Results: Median of blood loss from VSST / CKT / paired difference was 1.00 / 25.00 / 20.00 milliliters (p < 0.01). Mean ± SD of operative time from VSST / CKT / paired difference was 3.70 ± 2.27 / 8.52 ± 4.79 / 4.83 ± 4.60 minutes (95% CI of paired difference = 2.84 – 6.81, p < 0.01), However, there was no significant difference in daily (day0 – day14) postoperative pain (p = 0.10 – 0.96) from Pain Scale between both groups. Generalized estimating equation was used for prediction of pain scale by considering treatment group and postoperative day as independent variables. Postoperative day was statistically significant (p < 0.01) but treatment group was not significant (p = 0.77). Regarding postoperative bleeding, only two cases of delayed postoperative bleeding on the CKT side were found in this study. Conclusion: VSST is better than CKT in terms of efficacy (intraoperative blood loss and operative time) but not different in terms of postoperative pain.