Post Tonsillectomy Secondary Haemorrhage Cold Versus Hot Method

Background:
Tonsillectomy is a frequently performed otolaryngological procedure for
recurrent infections or obstructive symptoms. The surgical technique
may affect bleeding risk.
Objective:
The study aimed to compare post-tonsillectomy secondary haemorrhage
incold versus hot tonsillectomy techniques.
Methods:
This prospective study was conducted at an otolaryngology unit in
North Bengal Medical College & Hospital, Sirajganj, Bangladesh on 90
consecutive patients underwent tonsillectomy or adenotonsillectomy,
from January, 2023 to December, 2023, 45 by cold steel dissection and
45 by hot electrosurgical technique. Baseline factors and preoperative
Hb and platelet counts were recorded.
Results:
Both groups were comparable in demographics and baseline clinical
factors, including indication, recent URTI, NSAID exposure,
hemoglobin, and platelet count (all p>0.05). Haemostasis differed
significantly: ties were used more in the cold group (48.9% vs 13.3%)
and bipolar diathermy more in the hot group (75.6% vs 40.0%)
(p<0.001). Operative time was similar, but blood loss was lower with
the hot technique (median 26 vs 43 mL, p<0.001).
Conclusion:
Hot tonsillectomy significantly reduced intraoperative blood loss with
similar primary haemorrhage, but showed a higher, non-significant trend
toward secondar