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Harmonic Scalpel Tonsillectomy Versus Coblation Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Aim

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to comprehensively evaluate the efficacy of coblation versus harmonic scalpel methods among patients undergoing tonsillectomy.

Methods

PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Google Scholar databases were systematically screened from inception until October 2022. The outcomes were summarized as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with 95% confidence interval (CI) in a random-effects model.

Results

Six RCTs were analyzed, encompassing a sum of 461 patients (harmonic scalpel = 233 patients and coblation = 228 patients). The overall quality assessment was low risk of bias in two RCTs, some concerns of bias in three RCTs, and high risk of bias in one RCT. There was no significant difference between harmonic scalpel and coblation groups regarding the mean operative time (n = 6 RCTs, MD=-7.45 min, 95% CI [-15.26, 0.01], p = 0.06) mean intraoperative blood loss (n = 5 RCTs, MD=-36.03 ml, 95% CI [-77.46, 5.41], p = 0.09), and rate of postoperative hemorrhage (n = 5 RCTs, RR = 0.59, 95% CI [0.25, 1.39], p = 0.23). The overall postoperative pain score was significantly reduced in favor of the coblation group compared with the harmonic scalpel group (n = 5 RCTs, MD = 0.40, 95% CI [0.10, 0.69], p = 0.009)”.

Conclusions

The harmonic scalpel and coblation techniques share equal efficacy among patients undergoing tonsillectomy. The reduction in postoperative pain score provided by the coblation method is not clinically meaningful in clinical practice. Additional RCTs are needed to consolidate the power and quality of the presented evidence.

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Data availability

All data are available within the manuscript and its supplemental files.

Code availability

Review Manager Software version 5.4.0. for Windows.

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Authors and Affiliations

  1. Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait

    Ebraheem Albazee & Maisem Tariq AlHajri

  2. RCSI University of Medicine and Health Sciences, Dublin, Ireland

    Salman Hussain

  3. College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain

    Aysha Abduljabbar

  4. Department of Otorhinolaryngology and Facial Plastic Surgery, Canadian Medical Center, Sharqe, Kuwait City, Kuwait

    Mahmoud Abdelaziz Alsakka

  5. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

    Ahmed Abu-Zaid

  6. College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, 38163, United States of America

    Ahmed Abu-Zaid

Authors
  1. Ebraheem Albazee
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  2. Salman Hussain
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  3. Aysha Abduljabbar
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  4. Maisem Tariq AlHajri
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  5. Mahmoud Abdelaziz Alsakka
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  6. Ahmed Abu-Zaid
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Contributions

Ebraheem Albazee and Ahmed Abu-Zaid contributed to study conception, data analysis, study supervision, and manuscript writing. Salman Hussain, Aysha Abduljabbar, Maisem Tariq AlHajri, and Mahmoud Abdelaziz Alsakka contributed to literature review, data collection, data interpretation, and revision of manuscript for editorial and intellectual contents. All authors read and approved the final draft of manuscript.

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Correspondence to Ahmed Abu-Zaid.

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Albazee, E., Hussain, S., Abduljabbar, A. et al. Harmonic Scalpel Tonsillectomy Versus Coblation Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Indian J Otolaryngol Head Neck Surg 75, 3621–3627 (2023). https://doi.org/10.1007/s12070-023-04022-7

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  • DOI: https://doi.org/10.1007/s12070-023-04022-7

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