gms | German Medical Science

Introduction: The diameter of vessels within the tonsillar capsule increases significantly from inside to outside [1]. Therefore the question came up weather a preparation near the tonsillar capsule and bipolar hemostasis under microscopic view could decrease the postoperative hemorrhage rates following tonsillectomy in cold steel technique.

Methods: We performed a retrospective cohort study on the postoperative hemorrhage rates in patients treated by tonsillectomy with or without the use of a surgical microscope between December 2003 and December 2008 with respect to the need of a surgical control of the bleeding (R: return to theatre, N: no return, 0: on the day of surgery, 1: postoperative following the day of surgery).

Results: In total we studied 890 patients (365 male and 525 female) with a median age of 25.0 +/- 15.2 years (standard deviation); in 187 patients tonsillectomy was performed with the use of a microscope (M+). Hemorrhage requiring a surgical control were seen in the M+ group on the day of surgery (R0) in 0.53% and afterwards (R1) in 1.07% of the cases. Bleedings without a need of surgical intervention were observed in 0.53% (N0) and 3.21% (N1) respectively. Without the use of a microscope (M-) the corresponding rates were as follows: R0 – 0.14%, R1 – 1.56%, N0 – 0.28%, and N1 – 3.70%.

Conclusion: The use of a surgical microscope in tonsillectomy in a retrospective cohort study did not influence the postoperative hemorrhage rates following tonsillectomy statistically significant.