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Microdebrider May Be Best Tonsillectomy Technique

Procedure found to result in fewer complications than coblation, electrocautery approaches

TUESDAY, June 1 (HealthDay News) -- Microdebrider intracapsular tonsillectomy appears to have an edge over coblation and electrocautery when it comes to tonsillectomy complication rates, according to research published in the June issue of Otolaryngology -- Head and Neck Surgery.

Thomas Q. Gallagher, D.O., of the Naval Medical Center in Portsmouth, Va., and colleagues conducted a case-control study of 4,776 children ages 1 to 18 undergoing adenoidectomy, tonsillectomy or adenotonsillectomy by microdebrider, coblator or electrocautery to compare the rates of postoperative hemorrhaging and dehydration among the three techniques.

The researchers found that complications occurred in 80 patients (0.4 percent) overall. Major complications happened in 2.8 percent of those who underwent coblation, 3.1 percent who underwent electrocautery, and 0.7 percent who underwent microdebrider. Children who had their tonsils removed via coblation or electrocautery were 3.9 and 4.4 times, respectively, more likely to have complications than those whose tonsils were removed via microdebrider. Postoperative hemorrhaging was more likely in older children (8.5 versus 5.5 years), but age had no influence on postsurgical dehydration.

"In this 'real life' teaching hospital surgical setting in which three different techniques of tonsillectomy are routinely performed by a variety of resident and attending surgeons, microdebrider intracapsular tonsillectomy is associated with lower rates of post-tonsillectomy hemorrhage and dehydration when compared to coblation and electrocautery complete tonsillectomy technique," the authors write.

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