ORIGINAL ARTICLE Modern Technology–Assisted vs Conventional Tonsillectomy A Meta-analysis of Randomized Controlled Trials Vangelis G. Alexiou, MD, MSc; Mary Sheryll Salazar-Salvia, MD, MSc; Paul N. Jervis, BDS, FRCS; Matthew E. Falagas, MD, MSc, DSc Objective: To systematically review evidence regard- group, operative time was significantly shorter (WMD), ing modern technology–assisted tonsillectomy pertain- −4.09 minutes; 95% CI, −7.43 to −0.75 minutes; 760 pa- ing to operative time, intraoperative and postoperative tients), perioperative bleeding was significantly less (SMD, bleeding, postoperative pain, and other outcomes. −1.67; −2.80 to −0.53; 355 patients), and postoperative bleeding was significantly less (odds ratio, 0.28; 0.13 to 0.61; Design: A systematic search for randomized controlled 792 patients). Pain on the first and seventh postoperative trials comparing total tonsillectomies performed using days was significantly less in the VSS group (SMD, −1.73; vessel sealing systems (VSS), Harmonic Scalpel (HS), or 95% CI, −3.07 to −0.39; 740 patients; and SMD, −1.46; −2.35 radiofrequency ablation (ie, Coblation) with the con- to −0.57; 684 patients; respectively). For the HS group com- ventional technique of cold steel and/or electrocautery pared with the CS/EC group, the only studied outcome that dissection (CS/EC). Estimation of odds ratios and 95% differed significantly was perioperative bleeding, which
JAMA Otolaryngology - Head & Neck Surgery – American Medical Association
Published: Jun 1, 2011
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