Objective: To compare bleeding after partial intracapsular tonsillectomy (PIT) and bipolar diathermy tonsillectomy (BDT).
Design: Retrospective chart review.
Setting: Stollery Children's Hospital, tertiary pediatric referral centre.
Patients: All children (<or=17 years of age) who had tonsillectomy. Patients who had incomplete information or less than 2-weeks follow-up were excluded.
Main outcome measure: (1) Post-tonsillectomy bleeding, (2) other data collected included demographics, length of follow-up, indication(s) for surgery, other procedures performed, and co-morbidities.
Results: Over a 4.5-year period 677 patients (333 BDT, 344 PIT) were identified in our search, and 77 (38 BDT, 39 PIT) were excluded. The mean age was 7.7+/-3.8 years in the BDT group and 6.5+/-3.2 years in the PIT group. Sex distribution was similar in the 2 groups (chi square p=0.61). Twenty (6.8%) BDT patients experienced post-tonsillectomy bleeding, compared to three (0.98%) of PIT patients (p=0.0001, 95% CI 1.52-2.18, OR=7.32). Over 3 times as many PIT patients (153) had co-morbid conditions than BDT patients (44); this was statistically significant (chi square p<0.00001, 95% CI 1.78-2.38).
Conclusion: PIT results in significantly less post-tonsillectomy bleeding than BDT. These findings favor partial over total techniques with respect to reducing this important complication.