Meta Analysis On The Efficacy Of Low-temperature Coblation And Conventional Dissection On Tonsil

Objective:To systematically evaluate the efficacy of low-temperature coblation and conventional dissection in tonsillectomy so as to provide an evidence bassis for the clinical selection of surgical procedures. Methods:Retrieving Chinese Academic Journals, CNKI, Wanfang Database, VIP Information Resource System, CBM, OVID, PubMed and FEBM, the randomized controlled trials about the efficacy of low-temperature coblation and conventional dissection in tonsillectomy were included. The literature meeting the inclusion criteria was evaluated, and the meta-analysis was performed on those randomized controlled studies that met the quality standards using software RevMan5.2. Results:The 13 randomized controlled trials included covered a total of 1217 patients with 605 patients in the low-temperature coblation group and 612 patients in the conventional dissection group. Meta analysis showed that low-temperature coblation group was superior to conventional dissection group in the aspects of operation time [MD=-17.89,95%CI(-22.48,-13.30), P< 0.00001], intraoperative blood loss [MD=-32.50,95%CI(-37.21,-27.78), P<0.00001], pain scores 24h after operation [MD=-2.11,95%CI(-2.23,-1.98),P<0.00001], and time for recovering normal diet [MD=-2.41,95%CI(-3.05,-1.76), P<0.00001], and those differences were statistically significant. In terms of postoperative pain duration [MD=-0.94,95%CI(-2.24,0.35), P=0.15] and albuginea detachment time [MD=1.28,95%CI(-0.40,2.97), P=0.13], the results of both groups were similar and showed no statistically significant difference. Conclusions:Compared with conventional dissection, low-temperature coblation has shorter operative time, minimal blood loss, less pain 24h after operation and shorter time for recovering normal diet, but postoperative pain duration and albuginea detachment time are similar in two groups. It can be found that low-temperature coblation has obvious advantages and is worthy of promotion in clinical applications. For the quality restrictions and possible publication bias of the included studies, more double blind RCTs with high quality are required to further assess the effects.