Comparison of Outcomes by Bipolar Electrocautery Tonsillectomy Versus Cold Steel Dissection in Pediatric Tonsillectomy

Background: Innovative surgical techniques have all aimed to lower the likelihood of potential complications by shortening the duration of the procedure, limiting intraoperative blood loss, and improving patient safety and overall comfort. This study was planned to compare the outcomes of bipolar electrocautery dissection (BED) versus cold steel dissection (CSD) in pediatric tonsillectomy. Methods: This randomized controlled trial was conducted at the ENT department, Sir Ganga Ram Hospital, Lahore, Pakistan, from January 2024 to June 2024. A total of 110 (55 in each group) children aged 5-13 years, and planned to undergo tonsillectomy, were randomly allocated to study groups. In the BED group, tonsillectomy was performed employing the BED technique, and in the CSD group, patients underwent the conventional CSD method. Operative time, intraoperative blood loss, and postoperative pain were measured and compared among patients of both study groups. The statistical analysis was performed using “IBM-SPSS Statistics” version 26.0. An independent sample t-test or analysis of variance (for numeric data), or chi-square test (for categorical data) was applied for the comparisons between groups, taking p<0.05 as significant. Results: In a total of 110 patients, 67 (60.9%) were male. The mean age was 8.96±2.42 years. In the BED group, the mean operative time was 19.76±4.47 minutes versus 24.09±4.90 minutes in the CSD group (p<0.001). In the BED group, intra-operative mean blood loss in the BED and CSD groups were 10.95±2.00 ml and 22.87±2.37 ml, respectively (p<0.001). Wong-Baker faces pain rating scale noted significantly lower pain scores among children of the BED groups versus the CSD groups at 6-, 12-, 18-, and 24-hours following surgery (p<0.001). Conclusion: Bipolar electrocautery tonsillectomy showed significantly better outcomes as compared to cold steel dissection in children undergoing tonsillectomy.