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European Archives of Oto-Rhino-Laryngology
Published in:

09-07-2022 | Tonsillectomy | Review Article

Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials

Authors: Ebraheem Albazee, Khalid Hamad Al-Sebeih, Fares Alkhaldi, Hashem Majeed, Mohammad M Alenezi, Bader Alshammari, Duha Magzoub, Ahmed Abu-Zaid

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2022

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Abstract

Aim

This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated coblation versus laser (carbon dioxide and diode) tonsillectomy, with regard to various surgical and clinical outcomes.

Methods

We searched PubMed, CENTRAL, Scopus, and Web of Science for relevant from inception until March 2021. We evaluated risk of bias using the Cochrane Collaboration Tool. We summarized the outcomes as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with 95% confidence interval (CI). We conducted subgroup analysis based on the day of postoperative pain (day 1, day 7, and day 14) and type of postoperative hemorrhage (reactionary and secondary). In addition, we conducted subgroup analysis according to the type of laser.

Results

Five RCTs were analyzed. Three and two RCTs were evaluated as having “some concerns” and “low risk of bias”, respectively. Coblation tonsillectomy correlated with lower intraoperative blood loss (MD = -5.08 ml, 95% CI [− 7.33 to − 2.84], P < 0.0001) and lower operative time (MD = − 4.50 min, 95% CI [− 6.10 to − 2.90], P < 0.0001) compared with the laser tonsillectomy. However, there was no significant difference between both groups regarding the postoperative pain score (SMD = − 0.27, 95% CI [− 0.72 to 0.17], P = 0.27) and rate of postoperative hemorrhage (RR = 0.95, 95% CI [0.27–3.40], P = 0.23). Subgroup analysis reported similar insignificant difference between both groups according to the day of postoperative pain and type of postoperative hemorrhage.

Conclusions

Coblation tonsillectomy correlated with a significant reduction in intraoperative blood loss and operative time compared with the laser technique. Nevertheless, these effects do not seem clinically meaningful in surgical practice.
Appendix
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Metadata
Title
Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials
Authors
Ebraheem Albazee
Khalid Hamad Al-Sebeih
Fares Alkhaldi
Hashem Majeed
Mohammad M Alenezi
Bader Alshammari
Duha Magzoub
Ahmed Abu-Zaid
Publication date
09-07-2022
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 12/2022
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-022-07534-0

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