Post-operative bleeding is less after partial intracapsular tonsillectomy than bipolar total procedure

Objective: To compare bleeding after partial intracapsular tonsillectomy (PIT) and bipolar diathermy tonsillectomy (BDT). Design: Retrospective chart review. Setting: Stollery Children's Hospital, tertiary pediatric referral centre. Patients: All children (<= 17 years of age) who had tonsillectomy. Patients who had incomplete information or less than 2-weeks follow-up were excluded. Main outcome measure: (1) Post-tonsillectomy bleeding, (2) other data collected included demographics, length of follow-up, indication(s) for Surgery, other procedures performed, and co-morbidities. Results: Over a 4.5-year period 677 patients (333 BDT, 344 PIT) were identified ill Our search, and 77 (38 BDT, 39 PIT) were excluded. The mean age was 7.7 +/- 3.8 years in the BDT group and 6.5 +/- 3.2 years in the PIT group. Sex distribution was similar in the 2 groups (chi square p = 0.61). Twenty (6.8%) BDT patients experienced post-tonsillectomy bleeding, compared to three (0.98%) of PIT patients (p = 0.0001, 95% CI 1.52-2.18, OR = 7.32). Over 3 times as many PIT patients (153) had co-morbid conditions than BDT patients (44); this was statistically significant (chi square p < 0.00001, 95% CI 1.78-2.38). Conclusion: PIT results in significantly less post-tonsillectomy bleeding than BDT. These findings favor partial over total techniques with respect to reducing this important complication. (c) 2009 Elsevier Ireland Ltd. All rights reserved.