Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials

Albazee, Ebraheem; Al-Sebeih, Khalid; Alkhaldi, Fares; Majeed, Hashem; Alenezi, Mohammad M; Alshammari, Bader; Magzoub, Duha; Abu‐Zaid, Ahmed

doi:10.1007/s00405-022-07534-0

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…Whereas the observed extent of the injury was less severe than that of coblation, this result could be due to the high operating temperatures for TW ( 10 ). However, when comparing coblation with the laser technique, a recent pooled analysis revealed no substantial variation between the coblation and the laser procedures in terms of postoperative pain and bleeding ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Albazee,

Alshammari,

Alotaibi

et al. 2023

TAO

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Objective: In hopes of contributing to the decision about the best surgical option in tonsillectomy, we performed this work to compare the effectiveness of the thermal welding system (TW) and monopolar electrocautery (ME) tonsillectomy in terms of postoperative pain, postoperative bleeding, and operation time in patients undergoing tonsillectomy, to determine which procedure is most expected to enhance the postoperative quality of life. Methods: Digital databases, including PubMed, Scopus, Cochrane, Web of Science, and Google Scholar, were systematically screened from inception up to October 2022. The included randomized controlled trials (RCTs) were evaluated for risk of bias via the Cochrane tool (version 2). The outcomes were summarized as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with a 95% confidence interval (CI) in a random-effects model. Results: The three RCTs that met our criteria were included in the study. Overall, 151 patients had been enrolled in these three RCTs, in which 75 and 76 were allocated to the TW and ME groups, respectively. The postoperative pain levels were substantially reduced, favoring the TW arm over the ME arm [n=2 RCTs, SMD=-0.39, 95% CI (-0.67, -0.12), p=0.005]. Also, the analysis revealed a substantial variation between the TW and ME arms in terms of operation time [n=2 RCTs, MD=3.29 minutes, 95% CI (1.42, 5.17), p=0.0006]. However, the analysis revealed no substantial variation between the TW and ME arms in term of postoperative bleeding [n=3 RCTs, RR=0.40, 95% CI (0.06, 2.62), p=0.34]. Conclusion: This meta-analysis revealed that postoperative bleeding for tonsillectomy were similar between the ME and TW techniques. However, TW showed lower postoperative pain levels than ME statistically but without achieving significant clinical advantage.

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Section: Discussionmentioning

confidence: 99%

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Albazee,

Alshammari,

Alotaibi

et al. 2023

TAO

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“…1 While generally considered safe, this surgery does carry potential postoperative risks, including pain, bleeding, nausea, vomiting, and dehydration. 2,3 Among these complications, postoperative pain is a commonly encountered issue, and it can be alleviated through the use of medications like local anesthetics, opioids, non-steroidal anti-inflammatory drugs, and acetaminophen. 4 Nevertheless, the current treatments available for managing post-tonsillectomy pain are inadequate.…”

Section: Introductionmentioning

confidence: 99%

“…The decision to undergo this surgical intervention hinges on the severity and frequency of symptoms, as well as the patient's overall health and medical history 1 . While generally considered safe, this surgery does carry potential postoperative risks, including pain, bleeding, nausea, vomiting, and dehydration 2,3 . Among these complications, postoperative pain is a commonly encountered issue, and it can be alleviated through the use of medications like local anesthetics, opioids, non‐steroidal anti‐inflammatory drugs, and acetaminophen 4 .…”

Section: Introductionmentioning

confidence: 99%

Analgesic Efficacy of Ropivacaine Infiltration on Early Post‐Tonsillectomy Pain in Pediatrics

Albazee,

Abdelwahab,

Abdelaziz

et al. 2024

The Laryngoscope

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ObjectiveTo assess the analgesic efficacy of ropivacaine infiltration in the tonsillar fossa among pediatric patients undergoing tonsillectomy.Data SourcesPubMed, Scopus, Web of Science, and CENTRAL.Review MethodsEligible randomized controlled trials (RCTs) were assessed for bias using Cochrane's risk of bias tool (version 2). Our primary outcome was postoperative pain within 24 h, and secondary outcomes included operative time, intraoperative blood loss, time to first analgesia, bleeding, and nausea/vomiting. Data were pooled as mean difference, standardized mean difference, and risk ratio with a 95% confidence interval.ResultsOur review included 11 RCTs, with a total of 712 patients. The quality of studies varied and included low risk (n = 8 RCTs), some concerns (n = 2 RCTs), and high risk (n = 1 RCT) of bias. The primary endpoint of postoperative pain across all time points was significantly reduced in the ropivacaine group compared with the placebo group. Trial sequential analysis (TSA) of the postoperative pain depicted conclusive evidence and unnecessity for further RCTs. The mean operative time was significantly reduced in the ropivacaine group compared with the placebo group. However, there was no significant difference between both groups regarding additional clinical (i.e., mean intraoperative blood loss and mean time to first analgesia) and safety (i.e., rates of bleeding and nausea/vomiting) outcomes.ConclusionThis systematic review and meta‐analysis demonstrated the safety and postoperative analgesic efficacy of ropivacaine versus placebo among pediatric patients undergoing tonsillectomy. There was no significant difference between both groups regarding intraoperative blood loss, time to first analgesia, and rate of postoperative bleeding.Level of EvidenceLevel one Laryngoscope, 2024

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“…gical procedure that removes tonsillar tissue to alleviate inflammation and symptoms [3]. Traditional tonsillectomy with ultrasonic knife, high-frequency electric knife, despite the fact that it can completely remove the tonsils, is more traumatic for the patient.…”

Section: Introductionmentioning

confidence: 99%

Impact of Low-Temperature Plasma Radiofrequency Tonsillectomy on Pain, Inflammatory Markers, and Sleep Quality in Adults with Chronic Tonsillitis

Gu,

Gan

2024

Ann Ital Chir

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AIM: Chronic tonsillitis (CT) is a very common ear, nose, and throat disease worldwide, and in severe cases it can cause sleep apnea hypoventilation syndrome, which can affect the patient's health and can even be life-threatening. Low-temperature plasma radiofrequency tonsillectomy is one of the commonly used methods for treating CT with remarkable results, but more detailed reports are lacking. In this study, we aimed to explore the impact of low-temperature plasma radiofrequency tonsillectomy on pain, inflammatory markers, and sleep quality in adult CT patients for clinical reference. METHODS: A retrospective study was performed on adult patients diagnosed with CT at our hospital between June 2019 and October 2023. Patients were categorized into a control group receiving traditional tonsillectomy and a treatment group undergoing low-temperature plasma radiofrequency tonsillectomy. The groups were compared in terms of baseline characteristics, surgical parameters, visual analogue scale (VAS) scores, 36-item short form (SF-36) health survey questionnaire scores, inflammatory markers, and Pittsburgh Sleep Quality Index (PSQI) scores. Group differences in postoperative complications were also analyzed. RESULTS: There were 160 patients, 80 in the treatment group (50 males and 30 females, mean age 28.90 ± 2.46 years) and 80 in the control group (46 males, 34 females, mean age 28.89 ± 2.01 years). Differences between the two groups in terms of age, sex, duration of disease, smoking history, body mass index, and other baseline characteristics were not statistically significant (p > 0.05). Operation time, intraoperative bleeding, return to normal diet, and pseudomembrane detachment time in the treatment group were all significantly lower than in the control group (p < 0.05). There were no significant differences in VAS or SF-36 scores before treatment (p > 0.05). Post-treatment, both groups had lower VAS scores and higher SF-36 scores in the treatment group compared to the control group (p < 0.05). There were no significant differences in levels of inflammatory markers before treatment (p > 0.05). Both groups showed increased levels of inflammatory markers post-treatment, but the treatment group had lower post-treatment levels of Interleukin-6 (IL-6) and hypersensitive-C reactive protein (hs-CRP) than the control group (p < 0.05). No significant difference was observed between the two groups in PSQI scores before treatment (p > 0.05). Following treatment, both groups had decreased PSQI scores, with lower scores in the treatment group than in the control group (p < 0.05). The complication rate was lower in the treatment group than in the control group, with rates of 8.75% and 23.75%, respectively (p < 0.05). CONCLUSIONS: Low-temperature plasma radiofrequency tonsillectomy for adult CT patients offers advantages such as shorter surgical time, reduced intraoperative bleeding, minimal trauma, and fewer postoperative complications. This procedure significantly alleviates pain, improves quality of life, reduces levels of inflammatory markers, and enhances sleep quality.

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Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials

Cited by 9 publications

References 21 publications

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Analgesic Efficacy of Ropivacaine Infiltration on Early Post‐Tonsillectomy Pain in Pediatrics

Impact of Low-Temperature Plasma Radiofrequency Tonsillectomy on Pain, Inflammatory Markers, and Sleep Quality in Adults with Chronic Tonsillitis

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