Post-Operative Outcomes of Intracapsular Tonsillectomy with Coblation: A Systematic Review and Meta-Analysis
Krystal Lin, Trainee Intern, The University of Auckland, New Zealand
Authors List
Introduction
Tonsillectomy is one of the most commonly performed operations in the Western world. Post-operative bleeding and pain are relatively common complications following this operation. Intracapsular tonsillectomy with Coblation is one of a number of techniques developed to minimise post-operative complications. The safety of this technique is balanced against long-term symptom alleviation.
Aim
The aim of this systematic review and meta-analysis was to analyse available data on outcome and complications following intracapsular tonsillectomy with Coblation with the primary complication of interest being rates of post-tonsillectomy haemorrhage.
Methods
A pre-piloted search strategy was used to search Medline, Embase and the Cochrane library. Studies from the search published between December 2002 and January 2022 that met the inclusion criteria were included in the systematic review. Studies were screened by title, abstract and full text by two independent reviewers. Data was extracted by a pre-piloted form and results were summated and analysed.
Results
Data from 3,947 patients across 11 studies was used in quantitative analysis. The mean age was seven years, and the proportion of male patients was 51.1%. The overall proportion of total haemorrhage was 1.2% (CI 0.5%-1.9%) with majority being secondary haemorrhage. Post-operative pain scores were analysed qualitatively from eight studies and were not demonstrated to be more painful than extracapsular techniques. The proportion of patients requiring revision surgery was 1.6% (CI 0.2% - 3.0%).
Conclusion
Post-tonsillectomy haemorrhage rates in this systematic review and meta-analysis demonstrate that intracapsular tonsillectomy with Coblation has a low rate of post-tonsillectomy haemorrhage. The technique was not demonstrated to be more painful than extra-capsular tonsillectomy techniques and the proportion requiring further intervention was encouraging of the efficacy of this technique.
- Lin, K., Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hajarizadeh, B., The Kirby institute, University of New South Wales, Sydney, New South Wales, Australia
- Wood, A., Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Otolaryngology and Head and Neck Surgery, Waikato Hospital, Hamilton, New Zealand
- Selvarajah, K., Department of Otolaryngology and Head and Neck Surgery, Waikato Hospital, Hamilton, New Zealand
- Ahmadi, O., Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Otolaryngology and Head and Neck Surgery, Waikato Hospital, Hamilton, New Zealand
Introduction
Tonsillectomy is one of the most commonly performed operations in the Western world. Post-operative bleeding and pain are relatively common complications following this operation. Intracapsular tonsillectomy with Coblation is one of a number of techniques developed to minimise post-operative complications. The safety of this technique is balanced against long-term symptom alleviation.
Aim
The aim of this systematic review and meta-analysis was to analyse available data on outcome and complications following intracapsular tonsillectomy with Coblation with the primary complication of interest being rates of post-tonsillectomy haemorrhage.
Methods
A pre-piloted search strategy was used to search Medline, Embase and the Cochrane library. Studies from the search published between December 2002 and January 2022 that met the inclusion criteria were included in the systematic review. Studies were screened by title, abstract and full text by two independent reviewers. Data was extracted by a pre-piloted form and results were summated and analysed.
Results
Data from 3,947 patients across 11 studies was used in quantitative analysis. The mean age was seven years, and the proportion of male patients was 51.1%. The overall proportion of total haemorrhage was 1.2% (CI 0.5%-1.9%) with majority being secondary haemorrhage. Post-operative pain scores were analysed qualitatively from eight studies and were not demonstrated to be more painful than extracapsular techniques. The proportion of patients requiring revision surgery was 1.6% (CI 0.2% - 3.0%).
Conclusion
Post-tonsillectomy haemorrhage rates in this systematic review and meta-analysis demonstrate that intracapsular tonsillectomy with Coblation has a low rate of post-tonsillectomy haemorrhage. The technique was not demonstrated to be more painful than extra-capsular tonsillectomy techniques and the proportion requiring further intervention was encouraging of the efficacy of this technique.
