Guillotine versus dissection tonsillectomy: randomised, controlled trial
This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'. A single centre, randomised, controlled trial. One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Pati...
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| Veröffentlicht in: | Journal of laryngology and otology 2012-11, Vol.126 (11), p.1142-1149 |
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| container_title | Journal of laryngology and otology |
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| creator | Frampton, S J Ward, M J A Sunkaraneni, V S Ismail-Koch, H Sheppard, Z A Salib, R J Jain, P K |
| description | This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'.
A single centre, randomised, controlled trial.
One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.
Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.
This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection. |
| doi_str_mv | 10.1017/S002221511200196X |
| format | Article |
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A single centre, randomised, controlled trial.
One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.
Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.
This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.</description><identifier>ISSN: 0022-2151</identifier><identifier>EISSN: 1748-5460</identifier><identifier>DOI: 10.1017/S002221511200196X</identifier><identifier>PMID: 22963759</identifier><identifier>CODEN: JLOTAX</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>20th century ; Biological and medical sciences ; Blood Loss, Surgical - statistics & numerical data ; Child ; Child, Preschool ; Dissection ; Dissection - adverse effects ; Dissection - methods ; Female ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; Hemorrhage ; Humans ; Main Articles ; Male ; Medical sciences ; Mouth ; Otolaryngology ; Otorhinolaryngology. Stomatology ; Pain, Postoperative - epidemiology ; Palatine Tonsil - surgery ; Surgeons ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the upper aerodigestive tract ; Throat surgery ; Tonsillectomy - adverse effects ; Tonsillectomy - methods ; Tonsillitis - surgery ; Treatment Outcome</subject><ispartof>Journal of laryngology and otology, 2012-11, Vol.126 (11), p.1142-1149</ispartof><rights>Copyright © JLO (1984) Limited 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-56c2ae20534b640a9fd528866918cf672157dcc7457ffd1e4aaffcbd3e161eeb3</citedby><cites>FETCH-LOGICAL-c446t-56c2ae20534b640a9fd528866918cf672157dcc7457ffd1e4aaffcbd3e161eeb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S002221511200196X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,27901,27902,55603</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26569219$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22963759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frampton, S J</creatorcontrib><creatorcontrib>Ward, M J A</creatorcontrib><creatorcontrib>Sunkaraneni, V S</creatorcontrib><creatorcontrib>Ismail-Koch, H</creatorcontrib><creatorcontrib>Sheppard, Z A</creatorcontrib><creatorcontrib>Salib, R J</creatorcontrib><creatorcontrib>Jain, P K</creatorcontrib><title>Guillotine versus dissection tonsillectomy: randomised, controlled trial</title><title>Journal of laryngology and otology</title><addtitle>J. Laryngol. Otol</addtitle><description>This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'.
A single centre, randomised, controlled trial.
One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.
Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.
This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.</description><subject>20th century</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Dissection</subject><subject>Dissection - adverse effects</subject><subject>Dissection - methods</subject><subject>Female</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Main Articles</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mouth</subject><subject>Otolaryngology</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Pain, Postoperative - epidemiology</subject><subject>Palatine Tonsil - surgery</subject><subject>Surgeons</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the upper aerodigestive tract</subject><subject>Throat surgery</subject><subject>Tonsillectomy - adverse effects</subject><subject>Tonsillectomy - methods</subject><subject>Tonsillitis - surgery</subject><subject>Treatment Outcome</subject><issn>0022-2151</issn><issn>1748-5460</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kEtLxDAUhYMozvj4AW6kIIILq7lpkrbuZFBHEFyo4K6keUiGthmTVph_b4rjA8XV5XK-c-_hIHQA-Aww5OcPGBNCgAEQjKHkzxtoCjktUkY53kTTUU5HfYJ2QljgCOWYbKMJISXPclZO0fxmsE3jetvp5E37MIRE2RC07K3rkt51Icpxc-3qIvGiU661QavTRLqu9y5qKum9Fc0e2jKiCXp_PXfR0_XV42ye3t3f3M4u71JJKe9TxiURmmCW0ZpTLEqjGCkKzksopOF5TJsrKXPKcmMUaCqEMbJWmQYOWtfZLjr5uLv07nXQoa9iIKmbRnTaDaECAFoyzDGJ6NEvdOEG38V0kaJQFiQjNFLwQUnvQvDaVEtvW-FXFeBqrLn6U3P0HK4vD3Wr1Zfjs9cIHK8BEaRoTGxO2vDNccZLAiOXrZ-LtvZWvegfGf99_w45zZQW</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Frampton, S J</creator><creator>Ward, M J A</creator><creator>Sunkaraneni, V S</creator><creator>Ismail-Koch, H</creator><creator>Sheppard, Z A</creator><creator>Salib, R J</creator><creator>Jain, P K</creator><general>Cambridge University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20121101</creationdate><title>Guillotine versus dissection tonsillectomy: randomised, controlled trial</title><author>Frampton, S J ; Ward, M J A ; Sunkaraneni, V S ; Ismail-Koch, H ; Sheppard, Z A ; Salib, R J ; Jain, P K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-56c2ae20534b640a9fd528866918cf672157dcc7457ffd1e4aaffcbd3e161eeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>20th century</topic><topic>Biological and medical sciences</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Dissection</topic><topic>Dissection - adverse effects</topic><topic>Dissection - methods</topic><topic>Female</topic><topic>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Main Articles</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mouth</topic><topic>Otolaryngology</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Pain, Postoperative - epidemiology</topic><topic>Palatine Tonsil - surgery</topic><topic>Surgeons</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the upper aerodigestive tract</topic><topic>Throat surgery</topic><topic>Tonsillectomy - adverse effects</topic><topic>Tonsillectomy - methods</topic><topic>Tonsillitis - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frampton, S J</creatorcontrib><creatorcontrib>Ward, M J A</creatorcontrib><creatorcontrib>Sunkaraneni, V S</creatorcontrib><creatorcontrib>Ismail-Koch, H</creatorcontrib><creatorcontrib>Sheppard, Z A</creatorcontrib><creatorcontrib>Salib, R J</creatorcontrib><creatorcontrib>Jain, P K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laryngology and otology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frampton, S J</au><au>Ward, M J A</au><au>Sunkaraneni, V S</au><au>Ismail-Koch, H</au><au>Sheppard, Z A</au><au>Salib, R J</au><au>Jain, P K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Guillotine versus dissection tonsillectomy: randomised, controlled trial</atitle><jtitle>Journal of laryngology and otology</jtitle><addtitle>J. Laryngol. Otol</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>126</volume><issue>11</issue><spage>1142</spage><epage>1149</epage><pages>1142-1149</pages><issn>0022-2151</issn><eissn>1748-5460</eissn><coden>JLOTAX</coden><abstract>This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'.
A single centre, randomised, controlled trial.
One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.
Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.
This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>22963759</pmid><doi>10.1017/S002221511200196X</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of laryngology and otology, 2012-11, Vol.126 (11), p.1142-1149 |
| issn | 0022-2151 1748-5460 |
| language | eng |
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| source | MEDLINE; Cambridge University Press Journals Complete |
| subjects | 20th century Biological and medical sciences Blood Loss, Surgical - statistics & numerical data Child Child, Preschool Dissection Dissection - adverse effects Dissection - methods Female Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Hemorrhage Humans Main Articles Male Medical sciences Mouth Otolaryngology Otorhinolaryngology. Stomatology Pain, Postoperative - epidemiology Palatine Tonsil - surgery Surgeons Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the upper aerodigestive tract Throat surgery Tonsillectomy - adverse effects Tonsillectomy - methods Tonsillitis - surgery Treatment Outcome |
| title | Guillotine versus dissection tonsillectomy: randomised, controlled trial |
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