Intracapsular Coblation Tonsillectomy in Children Under Two - A Retrospective Case Series

Résumé du livre

Objective: Adenotonsillar surgery carries a recognised risk of post-operative haemorrhage. There is an increasing body of evidence and opinion that intracapsular tonsillectomy confers advantages in reducing the risk of post-operative bleeding. The aim of this study was to assess post-operative complications of intracapsular coblation tonsillectomy in children aged under 2 undergoing intracapsular tonsillectomy. Method: A retrospective note review was carried out using electronic notes of all under two year olds, who underwent intracapsular coblation tonsillectomy including adenotonsillectomy. Patients were included from May 2015 to August 2017. Data collected included patient age, indication, surgeon performing as well as primary and delayed complications. Results: There were a total of 33 patients identified. The mean surgical time of tonsillectomy and adenotonsillectomy was 16.5 minutes. There were no complications within the first 28 days. There were no delayed discharges due to pain. Two patients had a post-operative chest infection treated effectively with antibiotics. Four patients had delayed complications. Two had adenoidal regrowth and presented with sleep disordered breathing. Two were found to have tonsillar regrowth at 4 and 15 months. One of these patients required repeat tonsillectomy. All of these children were within the first 6 cases of the series. Conclusion: We have demonstrated that, in our unit, coblation intracapsular tonsillectomy has proved to be a safe procedure with a low level of complications. The fact that the re-growths occurred within the first few cases may be demonstrative of a learning curve.