Meta-analysis of modern technology–assisted vs conventional tonsillectomy

January 01, 0001

Meta-analysis of modern technology-assisted vs conventional tonsillectomy

These authors from multiple countries systematically reviewed evidence regarding modern technology-assisted tonsillectomy pertaining to operative time, intraoperative and postoperative bleeding, postoperative pain, and other outcomes. They conducted a meta-analysis of randomized controlled trials comparing total tonsillectomies performed using vessel sealing systems (VSS), Harmonic Scalpel (HS), or radiofrequency ablation (ie, Coblation) with the conventional technique of cold steel and/or electrocautery dissection (CS/EC). They included 33 trials involving 3139 patients.

They found: "For the VSS group compared with the CS/EC group, operative time was significantly shorter, -4.09 minutes; 760 patients; perioperative bleeding was significantly less, -1.67; and postoperative bleeding was significantly less (odds ratio, 0.28). Pain on the first and seventh postoperative days was significantly less in the VSS group (-1.73; 740 patients; and -1.46; 684 patients; respectively). For the HS group compared with the CS/EC group, the only studied outcome that differed significantly was perioperative bleeding, which was significantly less in the HS group (-37.71 mL; 535 cases). No difference was noted between the Coblation and CS/EC groups for any of the studied outcomes."

The authors concluded: "For tonsillectomies, the Coblation and Harmonic Scalpel techniques do not provide any significant advantage compared with CS/EC. Synthesis of the limited and heterogeneous data regarding vessel sealing systems showed a significant benefit in all studied outcomes."

These advanced technologies provide little or no clinically significant benefits and at what cost?

For the full abstract, click here.

Arch Otolaryngol Head Neck Surg 137(6):558-570, June 2011 © 2011 to the American Medical Association
Modern Technology-Assisted vs Conventional Tonsillectomy: A Meta-analysis of Randomized Controlled Trials. Vangelis G. Alexiou, Mary Sheryll Salazar-Salvia, Paul N. Jervis, Matthew E. Falagas. Correspondence to Dr. Alexiou: [email protected]

Category: D. Digestive. Keywords: tonsillectomy, vessel sealing systems, radiofrequency ablation, Harmonic scalpel, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 1 July 2011

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