Bowling DM; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1999; 15: 106.

Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02114, USA.

OBJECTIVE: To evaluate the effectiveness of Argon Beam Coagulation (ABC) in the prevention of hemorrhage post-tonsillectomy. ABC provides monopolar coagulation by arcing ionized argon gas to the target tissue; it is not a laser. METHODS: Two consecutive studies have been performed as follows: 1) A prospective case/control study of bleeding post-tonsillectomy in 344 patients. The same surgeon performed each procedure using an electrodissection technique. Final tonsil fossa hemostasis was achieved by ABC in 257 patients or by electrocoagulation (EC) in 87 patients. 2) A prospective, randomized, patient-blind study of post-tonsillectomy bleeding in 88 patients. The procedures were performed by one of two surgeons using either a mechanical or an electrodissection technique. Final hemostasis was achieved using ABC in one fossa and EC in the other fossa, with the sides chosen randomly. RESULTS: Post-tonsillectomy hemorrhage defined as the expectoration of fresh blood as opposed to blood streaked saliva. Adult: age >or = 16 years. Table 1: Frequency of Post-Tonsillectomy Hemorrhage - Case/Control Study. EC, ABC, TOTAL: Cases, Bled, Rate, Cases, Bled, Rate, Cases, Bled, Rate: Adult, 25, 5, 20%, 85, 4, 4.70%, 110, 9, 8.20%; Pediatric. 62, 4, 6.50%, 172, 1, 0.60%, 234, 5, 2.10%; TOTAL, 87, 9, 10.30%, 257, 5, 1.90%, 344, 14, 4.10%. Table 2: Frequency of Post-Tonsillectomy Hemorrhage, Patient as Control: EC, ABC; Tonsils, Bled, Rate, Tonsils, Bled, Rate; Adult, 26, 5, 19.20, 26, 2, 7.70%; Pediatric, 62, 1, 1.60%, 62, 0, 0.00%; TOTAL, 88, 6, 6.80%, 88, 2, 2.30%. In Table 1 the difference of 8.4% between the EC and ABC bleeding rates is significant with p=0.001. CONCLUSIONS: ABC is more effective than EC for hemostasis post-tonsillectomy. The reduction in adult post-tonsillectomy bleeding is particularly impressive.

Publication Types:

• Meeting Abstracts

Keywords:

• Adult
• Argon
• Blood Coagulation
• Blood Coagulation Tests
• Case-Control Studies
• Child
• Diathermy
• Electrocoagulation
• Hemorrhage
• Hemostasis
• Hemostasis, Endoscopic
• Hemostasis, Surgical
• Humans
• Lasers
• Longitudinal Studies
• Physical Therapy Modalities
• Tonsillectomy
• blood
• surgery
• hsrmtgs

Other ID:

• HTX/20602319

UI: 102194008

From Meeting Abstracts