Comparative systematic review and meta-analysis of the therapeutic effects of coblation tonsillectomy versus electrocautery tonsillectomy

Abstract

Background: Surgical removal of the primary lesion is a common treatment for chronic tonsillitis, recurrent tonsillitis, and tonsillar hypertrophy, and is the most widely performed surgery in otorhinolaryngology. With the development and progress of medical science and technology, the methods of tonsillectomy have gradually diversified, and it is of great significance to seek the best tonsillectomy method. This meta-analysis explored the advantages and disadvantages of coblation tonsillectomy (CT) and electrocautery tonsillectomy (ET). Methods:The keywords "coblation", "radiofrequency ablation", "electrocautery", and "tonsillectomy" were used to search the PubMed, Embase, Cochrane library, Clinicaltrials.gov, and Google Scholar databases, and randomized controlled trials (RCTs) of the 2 procedures since the establishment of the database were included. After screening and bias risk assessment, a meta-analysis was performed using Stata 16.0 software.Results: A total of 10 articles met the inclusion criteria and entered the final meta-analysis. There were 1,056 participants, including 547 patients who underwent CT and 509 patients who underwent ET. There was no significant difference in the operation time between CT and ET [standard mean difference (SMD) =0.39, 95% CI: -0.35 to 1.13, Z=1.044, P=0.296]. CT resulted in less intraoperative blood loss than ET (SMD =-2.62, 95% CI: -4.83 to -0.41, Z=-2.322, P=0.020). The postoperative pain score of CT was less than ET, but the difference was not statistically significant (SMD =-0.28, 95% CI: -0.58 to 0.01, Z=-1.866, P=0.062).CT resulted in less time to return to normal diet after surgery than ET, and the difference was statistically significant (SMD =-0.36, 95% CI: -0.60 to -0.12, Z=-2.918, P=0.004).Discussion: CT resulted in less intraoperative blood loss and faster postoperative recovery than ET, but there was no significant difference in operation time, postoperative pain, and the incidence rate of postoperative complications between the 2 groups.

Effect of comprehensive nursing intervention on wound pain and wound complications in patients with tonsillectomy: A meta‐analysis

“…Tonsillectomy is the most common surgical procedure in otorhinolaryngology 2 . In recent years, with the emergence of new equipment, intraoperative bleeding and other undesirable complications are decreasing in patients with tonsillectomy, but the patient's wound after the operation will still be strong pain, which will be aggravated by the patient's drinking and eating, and it will take at least 15 days to fully recover 1,3,4 . At present, post‐tonsillectomy pain is still the biggest problem for patients and otorhinolaryngology medical staff.…”

“…Tonsillitis is a common disease in otorhinolaryngology; traditional conservative treatment can only temporarily relieve the patient's symptoms, and after a period of time the disease will recur under the stimulation of some triggers, so the clinical work is usually surgical resection as the first choice of treatment 1 . Tonsillectomy is the most common surgical procedure in otorhinolaryngology 2 .…”

“…Tonsillitis is a common disease in otorhinolaryngology; traditional conservative treatment can only temporarily relieve the patient's symptoms, and after a period of time the disease will recur under the stimulation of some triggers, so the clinical work is usually surgical resection as the first choice of treatment. 1 Tonsillectomy is the most common surgical procedure in otorhinolaryngology. 2 In recent years, with the emergence of new equipment, intraoperative bleeding and other undesirable complications are decreasing in patients with tonsillectomy, but the patient's wound after the operation will still be strong pain, which will be aggravated by the patient's drinking and eating, and it will take at least 15 days to fully recover.…”

“… 2 In recent years, with the emergence of new equipment, intraoperative bleeding and other undesirable complications are decreasing in patients with tonsillectomy, but the patient's wound after the operation will still be strong pain, which will be aggravated by the patient's drinking and eating, and it will take at least 15 days to fully recover. 1 , 3 , 4 At present, post‐tonsillectomy pain is still the biggest problem for patients and otorhinolaryngology medical staff. Postoperative wound pain not only affects the patient's mood, sleep and diet, but also increases the chance of dehydration, bleeding and infection, and delays the patient's postoperative recovery, so effective control of postoperative pain is also an important indicator of nursing quality.…”

Intrapatient Comparison of Coblation versus Electrocautery Tonsillectomy in Children: A Randomized, Controlled Trial

“…However, some of the randomized studies failed to show differences in postoperative pain and bleeding [ 10 , 11 , 12 ]. A systematic review and meta-analysis of coblation versus electrocautery tonsillectomy in 2020 reported significantly reduced pain for coblation on the first postoperative day [ 13 ]; however, postoperative pain was not significantly different in a systematic review written in 2022 [ 14 ].…”