Bleeding during endoscopic sinus surgery (ESS) can interrupt the fl ow of the procedure and contribute to complications. Advances in microdebrider design now provide the ability to control bleeding with bipolar energy while suctioning and shaving polyps. We sought to examine the eff ects of this technology on blood loss and operating times during ESS for chronic rhinosinusitis with nasal polyps (CRS+P).
STUDY DESIGN
Retrospective case-control.
Methods
Eighty patients who underwent ESS for CRS+P by the same surgeon between January 2006 and May 2008, performed with either the PK Diego® (Gyrus ACMI-ENT Division, Bartlett, TN) bipolar microdebrider (PK group, n=40) or a standard microdebrider (n=40) were compared. Chart review examining demographics, comorbidities, and operative variables including blood loss, OR time, and complications was performed. Similar preoperative treatment and anesthesia protocols were used for all patients.
Results
The groups were well-matched (average age 43.1 years in both, 42.5% females vs. 47.5% in PK and control groups, respectively; p>0.05) and demonstrated similar disease burden on imaging (mean Harvard CT stage 3.12 for PK, 3.15 for controls; p>0.05). The PK group had significantly less intraoperative blood loss vs. controls (86.0 ml vs 123.0 ml respectively; p=0.015) and the use of this technology was associated with shorter OR times (88.9 min vs. 101.4 min for controls, p=0.026). There were no complications in either group.
CONCLUSION
Utilizing a microdebrider with bipolar capabilities during ESS may off er the advantages of decreased blood loss and shorter operating times in patients with nasal polyps.