University of Leeds, School of Medicine, Leeds, UK.
University of Manchester, School of Medicine, Manchester, UK.
Ear Nose Throat J. 2023 Apr;102(4):NP183-NP191. doi: 10.1177/0145561321994995. Epub 2021 Mar 15.
There is no consensus on the optimal tonsillectomy technique in adult patients. The study aims to identify all studies comparing the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy.
A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary outcomes were hemorrhage and postoperative pain. Secondary outcome measures included return to theatre, analgesia, intraoperative bleeding, diet, tonsillar healing, and operation time. Fixed-effects modeling was used for the analysis.
Six studies were identified enrolling a total of 1824 patients. There were no significant differences in terms of reactionary hemorrhage (OR = 1.81, = .51), delayed hemorrhage (OR = 0.72, = .20), or postoperative pain (mean difference = -0.15, = .45); however, there is a general trend favuring coblation. For secondary outcomes, no significant differences noted in terms of intraoperative bleeding, diet, and cases returning to theatre. Analgesia administration was either insignificant or higher in the coblation group. The coblation group had longer operation time and greater healing effect on tonsillar tissue.
There were no significant differences in outcomes for coblation and bipolar diathermy for adult tonsillectomy patients in this systematic review and meta-analysis.
成人患者扁桃体切除术的最佳技术尚无共识。本研究旨在确定所有比较等离子与双极电凝扁桃体切除术治疗成人患者的结果的研究。
根据系统评价和荟萃分析的首选报告项目进行系统评价和荟萃分析。主要结局指标为出血和术后疼痛。次要结局指标包括返回手术室、镇痛、术中出血、饮食、扁桃体愈合和手术时间。采用固定效应模型进行分析。
确定了 6 项研究，共纳入 1824 例患者。反应性出血（OR = 1.81， =.51）、延迟性出血（OR = 0.72， =.20）或术后疼痛（平均差异 = -0.15， =.45）方面无显著差异；然而，等离子组有一定的优势。在术中出血、饮食和返回手术室的病例方面，没有显著差异。等离子组的镇痛剂使用量要么无统计学意义，要么更高。等离子组的手术时间更长，对扁桃体组织的愈合效果更好。
在本系统评价和荟萃分析中，对于成人扁桃体切除术患者，等离子与双极电凝的结果没有显著差异。
