Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials

Mösges, Ralph; Hellmich, Martin; Allekotte, Silke; Albrecht, Kerstin; Böhm, Myriam

doi:10.1007/s00405-011-1535-9

Cited by 51 publications

(69 citation statements)

References 46 publications

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“…Another meta-analysis [30] looked at the rates of PTB in Coblation tonsillectomy publications and concluded to 0.9 ± 0.4% early PTB, 3.6 ± 0.7% delayed PTB, and 4.1 ± 0.7% overall PTB. These bleeding rates are above the averages in table 2 and the authors, who have been supported by the manufacturer, seem quite biased.…”

Section: Surgical Technique: Coblationmentioning

confidence: 99%

Hemorrhage after Tonsillectomy: Does the Surgical Technique Really Matter?

Gysin

Dulguerov

2013

ORL

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A thorough review of the publications on surgical techniques used for tonsillectomy is provided, emphasizing randomized studies and meta-analysis. In the assessment of the data it is important to clearly define and categorize the types of posttonsillectomy bleeding (PTB), as well as the various factors that have been associated with increased PTB. In recent audits of a large number of tonsillectomies, the PTB rates seem to concur: 1% early and 2.5% delayed PTB; 10% anamnestic, 2% objective, and 2% re-operation PTB. Objective PTB rates beyond 10% should require an audit. The bipolar technique seems associated with the least early PTB, while the cold technique is associated with the least delayed PTB. Because of the lack of large well-conducted randomized trials, it is difficult to conclude which technique is the best. With electrocautery techniques, the current power should be adjusted to the minimal level providing hemostasis. Surgical techniques for tonsillectomy that should probably be abandoned include monopolar electrocautery, Coblation, various lasers, and the harmonic scalpel. Vesselsealing systems might hold promise and deserve further evaluation. Tonsillotomy might be associated with less postoperative pain, but the hemorrhagic advantage in randomized studies is not obvious. Tonsil regrowth rates and efficacy to treat obstruction need also further evaluation.

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Section: Surgical Technique: Coblationmentioning

confidence: 99%

Hemorrhage after Tonsillectomy: Does the Surgical Technique Really Matter?

Gysin

Dulguerov

2013

ORL

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“…Many authors report only those haemorrhages that required second surgery, whilst the others report all the episodes of post-tonsillectomy bleeding [5]; thus, in the publications in which only the haemorrhages that needed surgical treatment are considered, the rate of post-tonsillectomy haemorrhage is lower, but mortality percentages rise, compared to those studies in which all haemorrhages are reported [50].…”

Section: Definition Of Bleeding and Chronology Of Haemorrhagic Complimentioning

confidence: 76%

“…Michael et al [12] in a study on 337 cases (145 operated by cold tech- [59], according to which, the increased frequency of bleeding in adults could be due to variables independent of the surgical technique, such as the variability in compliance of patients with the post-operative instructions (post-surgical diet and physical rest), smoking, presence of comorbidity, conditions of the tonsils, and coagulation defects.…”

Section: Age Of Patientmentioning

confidence: 99%

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

Motta¹,

Testa²,

Ferrillo³

et al. 2018

AOHNS

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“…Overall, the hemorrhage rate for Coblation procedure was found to be 4.1% (2.8% to 5.5%). [5] The mean surgery time of Coblation tonsillectomy ranged from 22.7 to 28.9 minutes in various studies (Stoker et al, Parson et al, Shah et al) [9,10,11] compared to 16.2 to 23 minutes for electrocautery. In a study by R Guragain, CL Bhusal they concluded that the mean duration of dissection tonsillectomy was 23.03 minutes in comparison to diathermy tonsillectomy which was 14.8 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…[1] The Coblation system is a plasmasurgical device for dissection of soft tissue using monopolar and bipolar coblation and hemostasis. [4,5] The Coblation process was first invented by Philip Eggers and HV Thapliyal in May 1999. Their technology was acquired by a California based company Arthrocare and trademarked under the name COBLATION-a contraction of controlled and ablation.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Cold Knife Adenotonsillectomy and Coblation Adenotonsillectomy

Singh¹,

Bhansali²

2015

jemds

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S: AIMS & OBJECTIVES: To compare intra and postoperative recovery after Cold dissection adenotonsillectomy (Procedure 1) and Coblation assisted adenotonsillectomy (Procedure 2) and to determine whether there is a significant difference between the two methods in terms of benefit to the patients. METHODS: A single blind comparative study of 60 pediatric patients aged 5 to 16 years undergoing adenotonsillectomy was conducted. The study assessed the results of two procedures in terms of duration, intra and post-operative bleeding, resumption to normal activity and quality of life assessment. The parameters were statistically compared between the two groups. RESULTS: 60 patients who underwent surgery (30 for cold dissection and 30 for coblation adenoton sillectomy) were found to have comparable demographic data with a mean age of 9.33 and 9.37 in procedure 1 & 2 respectively. The distribution of symptoms and grades of adenoid and tonsil hypertrophy was found statistically insignificant. The duration of the surgical procedure was significantly higher in the coblation group with a mean of 29.18 minutes in comparison to the other procedure with a mean of 22.8 minutes. The blood loss was around 20 ml for coblation versus 35 ml for cold steel method which was significant. The mean pain scores at 6hrs post-surgery were low in coblation group, similar results were seen at 12hrs and again at 2days there was low pain score. There was not much difference after 1 month in both the groups. Coblation procedure had a quicker return to normal diet with a mean duration of 2.67 days which was significant than the cold dissection method (mean-4.16 days). The quality of life scores were found similar in both the groups at the end of 6 months. CONCLUSION: The reduction of intraoperative blood loss in Coblation tonsillectomy was obvious and reduction of the postoperative pain and early return to normal diet were statistically significant. But the duration of surgery was found lengthened which can be attributed to inexperience. There was no significant variation recorded in long term pain and quality of life assessment.

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Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials

Cited by 51 publications

References 46 publications

Hemorrhage after Tonsillectomy: Does the Surgical Technique Really Matter?

Hemorrhage after Tonsillectomy: Does the Surgical Technique Really Matter?

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

A Comparative Study of Cold Knife Adenotonsillectomy and Coblation Adenotonsillectomy

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