Ahmad M U, Wardak A N, Hampton T, Siddiqui M R S, Street I
Department of Otorhinolaryngology, Hull University Teaching Hospitals NHS Trust, UK.
School of Medicine, University of Liverpool, UK.
J Laryngol Otol. 2020 Mar;134(3):197-204. doi: 10.1017/S0022215120000377. Epub 2020 Mar 2.
Cold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates.
This study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.
A systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded.
Seven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05).
The coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.
冷剥离是最常用的扁桃体切除技术，术后出血率低。低温等离子消融术是另一种技术，可能引起的疼痛较轻，但术后出血率可能较高。
本研究通过比较低温等离子消融术和冷剥离技术，评估小儿扁桃体切除患者的围手术期结局。
对截至2018年12月的所有小儿低温等离子消融术和冷剥离扁桃体切除术的比较研究进行系统评价。排除任何有成人参与的研究。记录疼痛、手术时间、术中、原发性和继发性出血等结局。
七项研究纳入总结性结局分析。低温等离子消融扁桃体切除术似乎导致的疼痛较轻、术中失血较少（p < 0.01）且手术时间较短（p < 0.01）。两组术后出血无显著差异（p > 0.05）。
与冷剥离相比，低温等离子消融扁桃体切除技术可能提供更好的围手术期结局，因此在小儿病例中，应在冷剥离扁桃体切除术之前选择该技术。
