Comparison of four different techniques in pediatric tonsillectomy

Abstract

Bu çalışmamızda tonsillektomi yöntemlerinin operasyon süreleri intraoperatif kanama postoperatif tam iyileşme süresi, postoperatif ağrı açısından karşılaştırırken uygun tonsillektomi tekniğini tespit etmeyi amaçladık. Gereç ve Yöntem: Harran Üniversitesi Tıp Fakültesi Kulak Burun Boğaz hastalıkları polikliniğinde 1 Ocak 2017 ile 31 Temmuz 2018 tarihleri arasında başvuran ve tonsillektomi ameliyatı uygulanan 160 pediatrik hasta çalışmaya dahil edildi. Bulgular: Çalışmaya alınan tüm hastalar randomize olarak 4 gruba (soğuk diseksiyon, bipolar koter, koblatör ve termal welding) ayrıldı. Ameliyat süresi, ameliyat sırasındaki kan kaybı ve postoperatif komplikasyonlar kaydedildi. Sonuç: Çalışma sonucunda termal welding ile yapılan operasyonlarda cerrahi süre daha kısaydı. İntraoperatif kanama, postoperatif ağrı termal welding tekniğinde diğer tekniklere göre daha az olduğu tespit edildi. Ayrıca normal diyete ve normal aktiviteye dönüş zamanı en kısa olarak termal welding yönteminde tespit edildi.

Thermal welding tonsillectomy versus cold dissection tonsillectomy: A systematic review and meta‐analysis of randomised controlled trials

“…Finally, only 14 RCTs met the eligibility criteria. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] Figure S1 summarises the PRISMA flowchart of literature search and study selection.…”

“…The majority of the included RCTs were conducted in Turkey, [8][9][10][11]13,[15][16][17][18][19][20] whereas two RCTs were conducted in Greece, 7,12 and one RCT was conducted in Saudi Arabia. 14 The duration of RCTs ranged from January 2005 to July 2017.…”

“…14 The duration of RCTs ranged from January 2005 to July 2017. Regarding the age group, eight RCTs included only paediatric patients, 8,9,[11][12][13]15,19,20 three RCTs included only adult patients 7,16,17 and three RCTs included both age groups. 10,14,18 Four RCTs had a self-control study design, in which the same patient had thermal welding on one side and cold dissection on the other side.…”

“…The overall quality of the included RCTs was 'low' risk of bias in seven RCTs, [7][8][9]12,14,16,18 'some concerns' of bias in three RCTs 11,13,19 and 'high' risk of bias in four RCTs. 10,15,17,20 Four RCTs 10,15,17,20 provided no information about the randomisation and allocation concealment processes, and three of them 15,17,20 had baseline imbalances which might have caused a significant problem in the randomisation process.…”

“…Within these lines, several randomised controlled trials (RCTs) have inspected the clinical outcomes of thermal welding versus cold dissection strategies for tonsillectomy. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, no conclusions can be certainly withdrawn, due to shortcomings pertaining to small sample sizes, different methodological qualities and inconsistent results. Moreover, there is no comprehensive report-thus far-that has systematically reviewed the existing body of literature to generate solid, evidence-based recommendations on the topic.…”