Adverse events of coblation or microdebrider in pediatric adenoidectomy: A retrospective analysis in 468 patients

Liu, Tiancong; Ji, Chao; Sun, Yang; Bai, Weiliang

doi:10.1002/lio2.949

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…The most remarkable is that it may impair the presence of enough tissue to perform histology assessment. In fact, despite the evidence is scarce, some authors have suggested that some secondary effects are more prone to occur with the coblation than microdebrider [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Coblator adenoidectomy in pediatric patients: a state-of-the-art review

Calvo-Henriquez,

RuedaFernandez-Rueda,

Garcia-Lliberos

et al. 2023

Eur Arch Otorhinolaryngol

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Introduction Adenoid hypertrophy is one of the main causes of nasal obstruction in ‘children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically when medical treatment fails. Different adenoidectomy techniques have been proposed to reduce morbidity and surgical risks, with a consequent marked increase in the use of new surgical procedures in recent years, with a progressive increase in the use of coblation. This state-of-the-art review aims to systematically review the current literature on the role of coblation in adenoidectomy. Methods The selection criteria included children submitted to adenoidectomy with coblator vs other techniques. 11 research questions were defined. 4 databases were explored by four authors: PubMed (Medline), the Cochrane Library, EMBASE and SciELO. The level of evidence and quality of the selected articles were assessed according to assessed according to the Quality Assessment Checklist of the National Institute for Health and Clinical Excellence. Results 20 studies met the inclusion criteria: 2 metanalysis, 12 randomized clinical trial, 2 non-randomized clinical trial, 1 prospective cohort study, and 3 retrospective cohort study. It encompassed a total population of 8375 participants. Regarding the different surgical techniques, 18 studies (excluding metanalysis) performed coblation (n = 1550), 6 microdebridement (n = 883), 15 curettage (n = 4016), and 1 suction coagulation (n = 1926). Conclusion Coblator adenoidectomy appears to offer better adenoid control compared to curettage, with a possible, although not confirmed lower rate of revision surgery. Similarly, this greater resection of adenoid tissue seems to be related to a greater reduction of nasal obstruction. The advantages of this technique are mainly less surgical bleeding—although it is not clear this is a clinically relevant difference, and less postoperative pain compared to cold curettage. The difference in pain is small, as adenoidectomy is not a painful surgery in general. There is little evidence on the control of OME and comparison with other techniques such as microdebrider adenoidectomy.

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Section: Discussionmentioning

confidence: 99%

Coblator adenoidectomy in pediatric patients: a state-of-the-art review

Calvo-Henriquez,

RuedaFernandez-Rueda,

Garcia-Lliberos

et al. 2023

Eur Arch Otorhinolaryngol

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“…Decreasing postoperative pain, reducing the operative and haemostasis duration, and minimising intraoperative and postoperative haemorrhage risk have brought attention to new surgical techniques and instrumentation. Different techniques are nowadays used for paediatric adenoidectomy: cold surgery—the conventional curettage (so-called blind curettage) with Beckmann curette; microdebrider (shaver) or endoscopic—assisted adenoidectomy; hot methods—electrocautery adenoidectomy [ 3 , 4 ], adenoidectomy with radiofrequency (coblation) [ 3 , 4 ], each method presenting its own advantages and possible side-effects.…”

Section: Introductionmentioning

confidence: 99%

“…Most authors agree that operative time and blood loss are significantly reduced in the case of electrocautery used in adenoidectomy surgery [ 5 , 6 , 7 , 8 ]. Whereas some authors report no complications after electrocautery adenoidectomy [ 9 , 10 ], others report a higher risk of secondary (delayed) haemorrhage and a greater incidence of neck pain (referred pain at the back of the child’s head) after bipolar electrocautery use (incidence up to 12%) [ 2 , 4 , 5 , 11 ], prolonged nasal obstruction, and velopharyngeal insufficiency symptoms.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Continuous Suctioning in Adenoidectomy Haemostasis—Clinical Study

Epure,

Hainarosie,

Gheorghe

2023

Medicina

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Introduction: Adenoidectomy is often the first major surgical challenge for the child’s haemostatic system, and controlling intraoperative bleeding can be a challenge for the surgeon. Different methods have been used intraoperatively by surgeons in order to enhance haemostasis. The cold air effect (continuous suctioning) has been used by some surgeons during adenoidectomy; however, no documentation of its haemostatic effect has been made. Objectives: Our prospective randomised controlled study enrolled a sample of 140 children undergoing adenoidectomy, and we studied the effect of continuous suctioning on the duration of haemostasis in paediatric adenoidectomy. Materials and Methods: We evaluated the effect of using continuous suctioning during haemostasis at the end of adenoidectomy procedures, comparing variables such as total surgery time, total haemostasis time, and intraoperative blood loss, between two groups: 70 adenoidectomy procedures where no continuous suctioning was used to enhance haemostasis versus the other 70 patients where continuous suctioning was the haemostatic method employed. RESULTS: After statistical analysis of the recorded data, we found that the total duration of adenoidectomy, the duration of haemostasis in adenoidectomy, and the intraoperative blood loss were significantly lower in patients in whom cold air was used for haemostasis. Intraoperative haemostasis failure (and consequent use of electrocautery for haemostasis) was more frequent in patients in whom no suctioning was used; as for the rates of postoperative primary bleeding after adenoidectomy, they were similar in both groups of patients, regardless of the technique used for haemostasis. Conclusions: The use of continuous suctioning during adenoidectomy haemostasis significantly shortens total surgical and haemostasis time, reduces intraoperative blood loss, and reduces the incidence of haemostasis failure (with the consequent need for bipolar electrocautery haemostasis).

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Adverse events of coblation or microdebrider in pediatric adenoidectomy: A retrospective analysis in 468 patients

Cited by 2 publications

References 22 publications

Coblator adenoidectomy in pediatric patients: a state-of-the-art review

Coblator adenoidectomy in pediatric patients: a state-of-the-art review

Efficacy of Continuous Suctioning in Adenoidectomy Haemostasis—Clinical Study

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