Electrocautery adenoidectomy outcomes: a meta-analysis.

OBJECTIVE

Review the published literature regarding clinical outcomes of suction electrocautery adenoidectomy (ECA) in pediatric patients.

DATA SOURCE

The MEDLINE database was systematically reviewed for articles reporting on the use of ECA.

REVIEW METHODS

Each study was independently reviewed by each investigator. Inclusion criteria included English language, sample size greater than five, and presentation of extractable data regarding outcomes with ECA. Random-effects modeling was used to estimate summary outcomes.

RESULTS

Nine studies met the inclusion criteria. The mean sample size was 276 patients with a grand mean age of 6.0 years. Random-effects modeling of intraoperative hemorrhage (4.1 cc vs 24.0 cc, 95 percent CI of difference = 16.5-23.1, P < 0.001) and operative time (10.0 minutes vs 18.4 minutes, 95 percent CI of difference = 0.82-2.90, P < 0.001) favored ECA vs curette adenoidectomy. Subjective success was reported in 95.0 percent (95% CI = 92.7%-97.3%, P < 0.001) of ECA patients with a grand mean of 5.8 months of follow-up. Adenoid regrowth was evaluated objectively (endoscopy or x ray) in only 116 of 2132 patients (5.4%), with an observed regrowth rate of 2.8 percent that (95% CI = 0%-5.5%, P = 0.052).

CONCLUSIONS

The preponderance of available evidence favors ECA vs curette adenoidectomy in terms of decreased intraoperative hemorrhage and operative time. Long-term outcome data for ECA are scarce but suggest a low regrowth and complication rate.