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Microdebrider cuts postoperative complications for tonsillectomies

Medtronic : 08 November, 2007  (New Product)
Medtronic has announced that an independent study has shown that intracapsular tonsillectomies, which use a microdebrider to remove at least 90 percent of tonsil tissue while sparing the tonsil capsule, had lower incidences of delayed postoperative haemorrhage.
The study also reported fewer return visits to the hospital or emergency department for treatment of pain or dehydration when compared to traditional electrodissection tonsillectomies.

“Complications of Tonsillectomy: A Comparison of Techniques,” conducted by the Division of Pediatric Otolaryngology at the Alfred I DuPont Hospital for Children in Delaware, reviewed post-operative outcomes for 2,944 patients undergoing tonsillectomy with or without adenoidectomy between Jan. 1, 2002 and May 31, 2005.

The powered intracapsular tonsillectomy group comprised 1,731 patients; an additional 1,212 patients were treated with electrodissection tonsillectomy.

The incidence of delayed haemorrhage (bleeding more than 24 hours after surgery) was 1.1 percent in the powered intracapsular group, as compared to 3.4 percent in the electrodissection group.

Delayed haemorrhage requiring treatment in the operating room was 0.5 percent and 2.1 percent for the intracapsular and electrodissection groups, respectively.

Treatment in the emergency department or hospital for postoperative pain or dehydration occurred for three percent of the intracapsular group and 5.4 percent of the electrodissection group.

Eleven, or 0.64 percent, of the intracapsular tonsillectomy patients required revision surgery. Including revision cases and hospital visits for pain, dehydration, and bleeding, complications were 8.8 percent in the total tonsillectomy group and 4.7 percent in the intracapsular group, a 47 percent reduction in complications.

“We are pleased but not surprised by the results of this study,” stated Richard Schmidt, MD of the Alfred I DuPont Hospital for Children, Division of Pediatric Otolaryngology in Delaware. “Prior to conducting the study we had noted that after powered intracapsular tonsillectomy and adenoidectomy (PITA), our patients had a more pleasant postoperative experience than after traditional tonsillectomy and adenoidectomy. However, the most significant value of PITA is in the decrease in postoperative bleeding. These bleeding events are extremely stressful to both the child and parents when they occur. PITA decreases such events and must be strongly considered.”

The results of the independent study were published in the September 2007 issue of the Archives of Otolaryngology–Head and Neck Surgery.
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