Coblation vs electrocautery tonsillectomy: Postoperative recovery in adults

Tan, Alvin Kah Leong; Hsu, Pon Poh; Eng, Soh Ping; Ng, Yuk Hui; Lu, Peter Kuo Sun; Tan, Su Ming; Say, J.; Chan, Yiong Huak

doi:10.1016/j.otohns.2006.03.008

Cited by 40 publications

(17 citation statements)

References 8 publications

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“…The results were similar to the results in the study conducted by Tan et al where the return to normal activity was earlier in the coblation group as compared to the monopolar electrocautery group. 8 However in a study conducted by Wang et al both the groups took similar time to return to normal activity. 6…”

Section: Discussionmentioning

confidence: 92%

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Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

Vyas

Sharma

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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Background: The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.Methods: A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared. Results: Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.Conclusions: Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.

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Section: Discussionmentioning

confidence: 92%

“…Similar statistically significant results were found when the pain scores were compared in the study conducted by Wang et al and Nithya et al 6,7 However, in a study conducted by Tan et al there was no difference between the pain scores between the two group. 8 This study was conducted only amongst pediatric population.…”

Section: Discussionmentioning

confidence: 99%

Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

Vyas

Sharma

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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“…One oral presentation was also excluded. As a result, 11 articles were included in this review. A flow diagram describing the process involved in study identification and inclusion and exclusion is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The Table lists the basic demographics of the patients from the 11 included studies . The study designs were all prospective randomized clinical trials with a level of evidence of Ib in all of them.…”

Section: Resultsmentioning

confidence: 99%

Adolescents and Adults Undergoing Temperature-Controlled Surgical Instruments vs Electrocautery in Tonsillectomy

Lee

Hsin

Lin

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Several temperature-controlled surgical instruments (TCSIs) have been used in tonsillectomy. However, to our knowledge, a meta-analysis of the differences between modern TCSIs and electrocautery (EC) has not been conducted. OBJECTIVE To compare TCSIs with EC with regard to the intraoperative and postoperative parameters of tonsillectomy.DATA SOURCES PubMed (MEDLINE), Embase, and the Cochrane Library were searched independently by 2 authors for relevant articles.STUDY SELECTION A literature search identified randomized clinical trials comparing the outcomes of TCSIs vs EC. The search keywords were harmonic scalpel, ultracision, PlasmaBlade, coblation, radiofrequency ablation, and tonsillectomy. Studies of adult and adolescent patients were included.DATA EXTRACTION AND SYNTHESIS Data from each study were extracted. A random-effects model was used in the pooled analysis.MAIN OUTCOMES AND MEASURES Four outcomes were analyzed: postoperative pain level on days 1, 2, 7, and 14 after surgery; postoperative bleeding; operative time; and intraoperative blood loss. RESULTSThis meta-analysis included 11 studies with a total of 629 unique patients. (Mean ages ranged from 16 to 55 years.) The studies were further categorized by the methods of comparison. Five articles used between-participant comparisons, and 6 used within-participant comparisons (of the left vs right sides of the participant's body). The pooled results of the studies with between-participant measures showed that postoperative pain scores were lower in the TCSI group on the first day (standardized mean differences [SMD], −0.41 [95% CI, −0.77 to −0.06]) and seventh day (SMD, −0.76 [95% CI, −1.47 to −0.04]). The pooled results of the studies with within-participant measures showed that the postoperative pain scores were lower in the TCSI group on the first day (SMD, −0.37 [95% CI, −0.63 to −0.12]) and second day (SMD, −0.60 [95% CI, −1.10 to −0.10]). The pooled analysis of overall bleeding, major bleeding, minor bleeding, primary bleeding, and secondary bleeding in both the types of studies with between-participant measures and those with within-participant measures showed no significant differences between the TCSI and EC groups. Intraoperative blood loss and operative time were not significantly different between the groups.CONCLUSIONS AND RELEVANCE Compared with EC, TCSIs were associated with significantly reduced pain on the first day after tonsillectomy, per this meta-analysis. The rates of overall bleeding, primary bleeding, secondary bleeding, major bleeding, and minor bleeding between TCSIs and EC were comparable. Intraoperative blood loss and operative time also showed no significant intergroup differences. Surgeons may consider using these modern instruments according to personal experiences, preferences, and cost-effectiveness criteria.

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“…This is likely to be related to decreased intraoperative damage to surrounding tissues, confirming the results of others. 18 , 20 – 23 Pain records and statistical aspects may be influenced by the use of oral medication, however, and although each patient received ibuprofen, variations in compliance can cause bias.…”

Section: Discussionmentioning

confidence: 99%

Coblation tonsillectomy under surgical microscopy: A retrospective study

et al. 2016

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ObjectiveA retrospective study to compare surgical parameters and postoperative pain in patients undergoing coblation tonsillectomy with or without microscopic guidance.MethodsData regarding duration of surgery and hospital stay, intraoperative blood loss, incidence of haemorrhage and postoperative pain scores were retrieved from the medical records of adult patients undergoing coblation tonsillectomy under direct vision or with microscopic guidance.ResultsThe incidence of secondary haemorrhage (>24 h postoperatively) was significantly lower and the duration of hospital stay was significantly shorter in the microscope group (n = 92) than the direct vision group (n = 76). Pain scores both at rest and while swallowing reached ≤3 (no significant impact on quality-of-life) significantly faster in the microscope group than the direct vision group.ConclusionsMicroscope-assisted coblation tonsillectomy decreases the duration of hospital stay and the incidence of postoperative secondary haemorrhage, and results in an early improvement in postoperative pain scores.

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Coblation vs electrocautery tonsillectomy: Postoperative recovery in adults

Abstract: Our results showed that coblation tonsillectomy has a faster recovery period and may offer advantages when compared to monopolar electrocautery tonsillectomy.

Cited by 40 publications

References 8 publications

Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

Adolescents and Adults Undergoing Temperature-Controlled Surgical Instruments vs Electrocautery in Tonsillectomy

Coblation tonsillectomy under surgical microscopy: A retrospective study

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