[The clinical efficacy of coblation tonsillectomy and conventional tonsillectomy in China: A Meta analysis]

Abstract

Objective:To systematically review the clinical efficacy of coblation tonsillectomy and conventional tonsillectomy in China. Method:Randomized controlled trials (RCT) of coblation tonsillectomy and conventional tonsillectomy were searched and retrieved through online databases (PubMed, Cumulative Index to Nursing and Allied Health, EMBASE, Cochrane Library, CBM, CNKI, VIP, WanFang, SUMsearch and Google search engine) and related literatures were reviewed up to 30 April, 2017. Two investigators independently screened literatures,extracted data and evaluated the risk of bias assessment tools for RCT using the Version 5.1.0 of Cochrane Handbook for Systematic Reviews of Interventions. Then, Meta analysis was performed using RevMan 5.3 software provided by the Cochrane Collaboration. Result:A total of 32 RCTs involving 3 197 tonsillectomy patients were included. The results of meta-analysis showed that: the operation time (MD=-17.03, 95%CI -19.78 to -14.28, P＜0.00 001), intraoperative blood loss (MD=-27.00, 95%CI -30.44 to -23.56, P＜0.00 001), postoperative pain in 24 hours (MD=-2.00, 95%CI -2.65 to -1.35, P＜0.00 001), time needed to regain the normal diet (MD=-2.01, 95%CI -2.60 to -1.42, P＜0.00001), formation time of white membrane (MD=-2.44, 95%CI -3.96 to -0.93, P=0.002) of patients in the coblation tonsillectomy group were all significantly lower than the conventional tonsillectomy group; while the exfoliation time of white membrane (MD=2.02, 95%CI 0.65 to 3.39, P=0.004) in the coblation tonsillectomy group was significantly longer than the conventional tonsillectomy group. Conclusion:Current evidence shows that, compared with the conventional tonsillectomy group, the coblation tonsillectomy group can significantly shorten the operation time, decrease intraoperative blood loss, alleviate postoperative pain degree during 24 hours, regain the normal diet early and form white membrane early, but delaye the exfoliation time of white membrane. Due to the limited kinds of literature and quality of the included studies, the above conclusions still need to be verified by carrying out more large scale samples and high quality randomized controlled trials (RCTs) studies.

Keywords: Meta analysis; coblation tonsillectomy; conventional tonsillectomy; randomized controlled trials.