Abstract
Objective
The aim of the study was to compare four different surgical techniques for tonsillectomy during free medical camps in Yemen, regarding type of anesthesia, complication rates, operative time, and cost of the operation.
Patients and methods
This prospective study was conducted from April 2006 to December 2011. There were 12 280 patients who underwent tonsillectomy in 26 hospitals in different Yemeni governorates, and operations were performed in 46 free medical camps. Under general anesthesia, we performed traditional dissection techniques (TDTs) and bipolar diathermy technique. Under local anesthesia, tonsillectomies were performed using TDT and guillotine excision technique.
Results
Of the 12 280 tonsillectomies patients, 53.7% were male patients and 46.3% were female patients. The median age of the patients was 11.5 years (range 3-30 years). Under general anesthesia, 6639 (54.1%) tonsillectomies were performed; of these, 86.1% were performed by TDT, whereas 13.9% were performed by bipolar diathermy technique. Under local anesthesia, 5641 (45.9%) tonsillectomies were performed; of these, 81% were performed by TDT, whereas 19% were performed by guillotine excision technique. Post-tonsillectomy hemorrhage was low in patients operated by TDT as compared with the other techniques. No significant differences were found in operative time between the four surgical techniques. The costs of tonsillectomy ranged between 30 and 37$.
Conclusion
The TDT is the most common method performed in the free medical camps, is handy, favorite, less costly, and comfortable for our patients, and is suitable for our work environments, experiences, and equipments. We recommend this technique for the same circumstances as a day-case tonsillectomy. Although less postoperative hemorrhage was observed in traditional surgery under general anesthesia, surgery under local anesthesia is safer and less costly.