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

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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.

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Authors and Affiliations

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

    Ebraheem Albazee, Hashem Majeed & Bader Alshammari

  2. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Kuwait University, Jabriya, Kuwait

    Khalid Hamad Al-Sebeih

  3. Primary Care Department, Jahra Health Region, Saad Al-Abdullah Health Care Centre, Jahra, Kuwait

    Fares Alkhaldi

  4. Department of Internal Medicine, Jahra Hospital, Jahra, Kuwait

    Mohammad M Alenezi

  5. School of Public Health, The University of Memphis, Memphis, TN, USA

    Duha Magzoub

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

    Ahmed Abu-Zaid

  7. Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, 38163, USA

    Ahmed Abu-Zaid

Authors
  1. Ebraheem Albazee
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  2. Khalid Hamad Al-Sebeih
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  3. Fares Alkhaldi
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  4. Hashem Majeed
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  5. Mohammad M Alenezi
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  6. Bader Alshammari
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  7. Duha Magzoub
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  8. Ahmed Abu-Zaid
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Contributions

EA contributed to study conception, study design, data collection, data analysis, write up of original draft of manuscript, and review of manuscript for editorial and intellectual contents. KHA-S, FA, HM, MMA, BA, and DM contributed to literature review, data collection, and review of manuscript for editorial and intellectual contents. AA-Z contributed to study conception, supervision, data analysis, write up of original draft of manuscript, and review 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., Al-Sebeih, K.H., Alkhaldi, F. et al. Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol 279, 5511–5520 (2022). https://doi.org/10.1007/s00405-022-07534-0

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