Plasma Ablation vs Other Hot Techniques for Tonsillectomy: A Meta‐analysis

Abstract

Objective To evaluate whether plasma ablation tonsillectomy is superior to other hot techniques in reducing postoperative morbidity. Data Sources The databases of PubMed, EMBASE, and Web of Science were used to search the literature, from inception to January 2, 2020. Randomized controlled trials (RCTs) that compared plasma ablation tonsillectomy with any other hot techniques were eligible. Review Methods A modified Cochrane tool was used to assess the risk of bias. The standardized mean difference (SMD) and 95% confidence interval (CI) were used to estimate pooled effects of postoperative pain, and the risk ratio (RR) was used for postoperative bleeding. Subgroup analysis was prespecified to explore the source of heterogeneity. The evidence quality of each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results A total of 15 RCTs were included (n = 1293). Comparing with other hot techniques, plasma ablation tonsillectomy may cause less pain on postoperative day 7 (SMD, −0.53; 95% CI, −0.84 to −0.23). However, the magnitude of the difference may be clinically meaningless. There were no significant differences not only in terms of postoperative pain on day 1 and day 3 but also in the incidence of postoperative bleeding, reoperation hemostasis, and return to normal diet and activities between the 2 groups. Conclusion There is still substantial uncertainty on postoperative pain, bleeding, and recovery. The current evidence is insufficient to demonstrate that plasma ablation is superior to other hot techniques for tonsillectomy.

Alternative Approach for the Treatment of Conjunctivochalasis: Plasma-Based Conjunctivoplasty

“…7,8 Modern cold plasma devices produce mobile ions from atmospheric gas, enabling the superficial layers of the target tissue to transform from a solid form to a gaseous state at low temperatures. 9 Thus, while deep tissues are protected, complications such as thermal damage, necrosis, and inflammation in the surrounding tissues are also prevented. These features provide clinically reduced postoperative pain and discomfort, faster recovery, minimal amount of complications, and excellent cosmetic results.…”