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Coblation versus cold dissection in paediatric tonsillectomy: a systematic review and meta-analysis

Published online by Cambridge University Press:  02 March 2020

M U Ahmad ,
A N Wardak ,
T Hampton ,
M R S Siddiqui  and
I Street
M U Ahmad*
Affiliation:
Department of Otorhinolaryngology, Hull University Teaching Hospitals NHS Trust, UK
A N Wardak
Affiliation:
School of Medicine, University of Liverpool, UK
T Hampton
Affiliation:
Department of Otorhinolaryngology, Alder Hey Children's Hospital, Liverpool, UK
M R S Siddiqui
Affiliation:
Department of Surgery, Croydon University Hospital, London, UK
I Street
Affiliation:
Department of Otorhinolaryngology, Alder Hey Children's Hospital, Liverpool, UK
*
Author for correspondence: Dr Mohammad Usman Ahmad, Department of Otorhinolaryngology, Hull University Teaching Hospitals NHS Trust, Hull, UK E-mail: m.u.ahmad@doctors.org.uk
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Abstract

Background

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.

Objective

This study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.

Methods

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.

Results

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).

Conclusion

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.

Keywords

TonsillectomyDissectionRadiofrequency AblationPediatricsPainHemorrhage
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 3 , March 2020 , pp. 197 - 204
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Dr M U Ahmad takes responsibility for the integrity of the content of the paper

Presented orally at the Students and Foundation Doctors in Otolaryngology UK session at the British Academic Conference in Otolaryngology, 5 July 2018, Manchester, UK.

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