1.
Postoperative hemorrhage following coblation tonsillectomy with and without suture: A randomized study in Chinese adults
Liu Q, Zhang Y, Lyu Y
American journal of otolaryngology. 2020;42(1):102760
Abstract
PURPOSE Coblation tonsillectomy (TE) increases gradually in China. Hemorrhage is the main complication after tonsillectomy. The conclusions of the studies about suture after tonsillectomy are conflicting. To compare the post-tonsillectomy hemorrhage (PTH) rates in patients who underwent coblation with vs. without suture. MATERIALS AND METHODS This was a randomized controlled study of adult patients who underwent coblation TE at our hospital between 01/2017 and 08/2019. The patients were randomized to TE with or without suture. The primary endpoint was the secondary PTH. The secondary endpoints included the primary PTH, grade of PTH, and incidence of PTH within 4 weeks post-TE. RESULTS There were no differences between the two groups regarding sex, age, disease course, and BMI (all P > 0.05). The occurrence of secondary PTH was lower in the suture group compared with the non-suture group (2.8% vs. 7.7%, P = 0.016). Compared with non-suture group, the incidence of PTH within 4 weeks (2.8% vs. 10.6%, P = 0.009) and the PTH degree (P = 0.02) were all significantly lower in the suture group. CONCLUSION Intraoperative suture reduces the secondary PTH in adult patients who underwent coblation tonsillectomy. The incidence of PTH within 4 weeks, PTH degree and pain might all improved for intraoperative suture.
2.
Comparison between the effect of endoscopic-assisted low temperature plasma and electric planer on the treatment of adenoid hypertrophy: a Meta-analysis
Xie S, Zhang Y, Xu Z, Zhang J, Wu X, Sun H
Zhong Nan Da Xue Xue Bao. Yi Xue Ban = Journal of Central South University. Medical Sciences. 2017;42((6)):706-712.
Abstract
OBJECTIVE To compare the effect of endoscopic-assisted low temperature plasma (ELTP) and electric planer (EP) on the treatment of adenoid hypertrophy. Methods: We searched China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database, Chinese Biomedical Literature (CMB), PubMed, Embase, Cochrane Database, and collected the randomized controlled studies regarding the effect of ELTP and EP on the treatment of adenoid hypertrophy from January 2007 to June 2016. Methodologies were used to evaluate the included studies, and Meta-analysis was performed by Revman 5.2. Results: Thirteen studies including 1 448 patients fulfilled the study requirement. Seven hundred and twenty-two patients were treated with ELTP, and 726 patients were treated with EP. The Meta-analysis showed: compared with EP, ELTP could improve the cure rare (OR=3.19, 95% CI 1.42 to 7.15, P=0.005), reduce the blood loss during surgery (MD=-20.35, 95% CI -20.84 to -19.87, P<0.001), shorten the operation time (MD=-15.71, 95% CI -18.06 to -12.17, P<0.001), and reduce the incidence of complications (OR=0.13, 95% CI 0.06 to 0.30, P<0.001), while there was no difference between the 2 groups in the postoperative residual rate of adenoid, postoperative hemorrhage rate and the rate of torus tubarius injury. Conclusion: Comparing with EP, ELTP shows more advantages in the adenoidectomy.
3.
Comparison of fibrin glue and Vicryl sutures in conjunctival autografting for pterygium surgery
Wang X, Zhang Y, Zhou L, Wei R, Dong L
Molecular Vision. 2017;23:275-285.
Abstract
PURPOSE To compare clinical parameters and the tear levels of inflammatory cytokines between pterygium surgery using sutures or fibrin glue. METHODS Fifty-six patients with primary pterygium were divided into the suture group and the glue group, in which the autograft was secured with 10-0 Vicryl sutures and fibrin glue, respectively. A questionnaire, slit-lamp examination, Schirmer test, and visual acuity test were performed in all participants. Real-time quantitative PCR (q-PCR) was used to analyze the expression of genes in pterygium and healthy conjunctival tissues. Based on the qPCR results and literature reports, five inflammatory cytokines, including hepatocyte growth factor (HGF), fibroblast growth factor 2 (FGF2), transforming growth factor-beta1 (TGF-beta1), matrix metalloproteinase 2 (MMP2), and tumor necrosis factor-alpha (TNF-alpha), were selected, and their protein levels were measured with enzyme-linked immunosorbent assay (ELISA) in patient tears before surgery as well as at postoperative day 1, 7, and 30. RESULTS There are 28 patients in either the suture or the glue group. The average duration of surgery was 20.17 +/- 3.23 min for the glue group and 32.42 +/- 4.47 min for the suture group (p = 0.000). Visual acuity in both groups was improved (p = 0.002) after the surgical procedures. There were more symptoms in the suture group than in the glue group at postoperative day 7 (p = 0.002). Postoperative symptoms disappeared in both groups at 1 month after surgery. Recurrence was observed in one case in the glue group and in two cases in the suture group at the 6 month postoperative follow-up (p = 0.714). In comparison to the preoperative levels (4.33 +/- 0.43 ng/ml for the suture group; 4.20 +/- 0.26 ng/ml for the glue group), the levels of TNF-alpha in tears increased in the suture group (5.02 +/- 0.49 ng/ml, p = 0.016) and decreased in the glue group (3.84 +/- 0.35 ng/ml, p = 0.052) on postoperative day 1. The glue treatment induced higher HGF production (4.78 +/- 1.25 ng/ml) than the suture treatment (3.04 +/- 1.18 ng/ml) at postoperative day 1 (p = 0.020). Higher levels of TGF-beta1 in the glue group were detected at postoperative day 1 (3.71 +/- 0.18 ng/ml) and postoperative day 30 (4.50 +/- 0.51 ng/ml), compared to those in the suture group, respectively (2.74 +/- 0.21 ng/ml, p = 0.000 for day 1; 3.36 +/- 0.96 ng/ml, p = 0.017 for postoperative day 30). CONCLUSIONS Fibrin glue is effective and safe for attaching conjunctival autografts with an easy surgical procedure, shortened operating time, and less postoperative discomfort. In the early postoperative period, the protein expression of inflammatory cytokines implicates that fibrin glue may induce accelerated healing and subdued inflammation on the ocular surface compared to sutures.