Chuang, Fred, Jones, Rhondda, Quail, Gavin, Whitfield, Bernard, and Ahluwalia, Sukhbir (2024) Rates of post-tonsillectomy haemorrhage between BiZact™ and bipolar tonsillectomy—a retrospective study. Australian Journal of Otolaryngology, 7 (5). 5.

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Abstract

Background: Tonsillectomy is a common procedure indicated in patients with recurrent tonsillitis or more commonly sleep-disordered breathing. Patient re-presentations to healthcare facilities occur due to complications such as pain, dehydration, and bleeding. Minimising these complications can significantly reduce the strain on local healthcare centres. The study identifies and compares the incidence of post-tonsillectomy haemorrhage (PTH) between BiZact™, a novel tonsillectomy device, and the traditional bipolar tonsillectomy. Methods: A retrospective single surgeon cohort study of PTH between two tonsillectomy devices was performed during 2018–2022. A historical chart review of emergency department PTH re-presentations in Far North Queensland was correlated with the corresponding surgeon and tonsillectomy method. The severity of PTH was graded by the Stammberger classification. Patients of all ages receiving bilateral tonsillectomies were included in the study, however, tonsil biopsies and unilateral tonsillectomies were excluded. A two-tailed Fisher exact test was performed to identify differences in the PTH rates. All analyses used R version 4.2.1. Results: In a study of 1,356 patients, the BiZact™ tonsillectomy technique showed a lower likelihood of PTH than the bipolar diathermy technique [P=0.04, odds ratio (OR) 0.64, 95% confidence interval (CI): 0.40–1.00]. The BiZact™ group had significantly reduced rates of secondary haemorrhage (P=0.003, OR 0.42, 95% CI: 0.23–0.76), and no cases of primary haemorrhage were reported. There was no significant difference in the timing of bleeding events between the two techniques. BiZact™ tonsillectomy also had a significantly lower rate of patients returning to theatre than bipolar tonsillectomy (P=0.02, OR 0.17, 95% CI: 0.02–0.85). Conclusions: The BiZact™ tonsillectomy technique has become increasingly popular due to its ease of use and efficiency. Our study demonstrates a significant decrease in hospital readmissions, PTH, and the need for returning to the operating room, particularly among adult patients who undergo BiZact™ tonsillectomy.

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