Mularczyk Chris, Walner David L, Hamming Katherine K
University of Illinois, College of Medicine, Urbana-Champaign, IL, USA.
Advocate Children's Hospital, Pediatric Otolaryngology, Pediatric Airway Center, Park Ridge, IL, USA; Rosalind Franklin University of Medicine and Science, Departments of Surgery and Pediatrics, North Chicago, IL, USA.
Int J Pediatr Otorhinolaryngol. 2018 Jan;104:29-31. doi: 10.1016/j.ijporl.2017.10.033. Epub 2017 Oct 25.
To compare and contrast coblation and microdebrider with touch-up electrocautery (ME) for adenoidectomy in children.
Patients <18 years old undergoing adenoidectomy without tonsillectomy were selected for this prospective, single-blinded, randomized controlled trial. Participants were enrolled into one of two groups based on birth date: coblation or ME. The surgeons completed a standard survey about intraoperative factors for each method. Recovery nurses filled out a standardized survey postoperatively. A third standardized survey was completed via a phone interview with the parent or patient caregiver on postoperative day 3 to assess procedure outcomes. The survey results were then compared using ANOVA statistical analysis.
50 patients were enrolled in the coblation group and 51 were enrolled in the ME group. There was no significant difference in mean age between the coblation (4.96 years) and ME groups (4.58 years) (p = 0.525). The mean time (in minutes) for coblation (5.50) was significantly lower than ME (9.47) when controlling for the confounder: surgical site exposure (p < 0.001). The surgical time was significantly influenced by the quality of exposure/visualization (p = 0.037). The coblator method had significantly less intraoperative blood loss compared to ME (p < 0.001). There was a statistically significant difference between coblation (1.53) and ME (2.05) for days of pain (p = 0.045) when controlling for the confounder adenoid size.
In our study we found that coblation demonstrated significantly less intraoperative time and less blood loss, as well as a shorter duration of postoperative pain, when compared to ME for adenoidectomy.
比较并对比低温等离子消融术与微切割器联合辅助电凝术（ME）在儿童腺样体切除术中的应用。
选取18岁以下未行扁桃体切除术的腺样体切除术患者进行这项前瞻性、单盲、随机对照试验。根据出生日期将参与者分为两组：低温等离子消融术组或ME组。外科医生完成了关于每种方法术中因素的标准调查。康复护士在术后填写了标准化调查问卷。在术后第3天通过电话采访家长或患者护理人员完成了第三次标准化调查，以评估手术效果。然后使用方差分析统计分析比较调查结果。
低温等离子消融术组纳入50例患者，ME组纳入51例患者。低温等离子消融术组（4.96岁）和ME组（4.58岁）的平均年龄无显著差异（p = 0.525）。在控制混杂因素手术部位暴露的情况下，低温等离子消融术的平均时间（分钟）（5.50）显著低于ME组（9.47）（p < 0.001）。手术时间受暴露/可视化质量的显著影响（p = 0.037）。与ME相比，低温等离子消融术方法术中失血显著更少（p < 0.001）。在控制混杂因素腺样体大小的情况下，低温等离子消融术组（1.53）和ME组（2.05）的疼痛天数存在统计学显著差异（p = 0.045）。
在我们的研究中，我们发现与ME相比，低温等离子消融术在腺样体切除术中显示出术中时间显著更短、失血更少以及术后疼痛持续时间更短。
