Secondary Heamorrhage After Cold Steel Tonsillectomy: An Audit Performed in Shalamar Hospital

Abstract

Introduction: Tonsillectomy is a common surgical procedure in which post tonsillectomy heamorrhage remains the most serious complication. The cold steel dissection method is the oldest and safest method used to perform tonsillectomies.

Aims & Objectives: This study was done to see the frequency of post-tonsillectomy heamorrhage with cold steel dissection method. It was a clinical audit performed retrospectively to compare our results with International standards.

Place and duration of study: Our clinical audit was conducted at Otolaryngology department in Shalamar Hospital, Lahore, Pakistan. This study was conducted in a period of 6 months.

Material & Methods: The charts of patients (n=344) that underwent tonsillectomy at Shalamar Hospital from January 2016 till December 2019 were retrospectively viewed, in a cross-sectional, pilot study, using convenience sampling technique. All the tonsillectomy procedures were performed using the cold steel dissection method. Frequencies were recorded and chi-square test was applied.

Results: The complication of secondary heamorrhage occurred in 7 patients and the frequency was calculated as 2%. A significant difference (P=0.01) of age was found in patients suffering from secondary heamorrhage. The incidence was lower in patients below 18 years of age (0.7%) as compared to patients above 18 years of age (7.14%). The rate of heamorrhage was found to be slightly higher in males than in females (2.6% and 1.31% respectively).

Conclusion: We conclude that the rate of secondary heamorrhage in our institution is up to the rate reported in literature. Different hot techniques for tonsillectomy should also be performed in clinical settings and compared with the standard cold steel dissection tonsillectomy.