TY - JOUR
T1 - Systematic review of the safety of electrosurgery for tonsillectomy
AU - Mowatt, Graham
AU - Cook, Jonathan Alistair
AU - Fraser, Cynthia Mary
AU - McKerrow, W. S.
AU - Burr, Jennifer Margaret
PY - 2006/4
Y1 - 2006/4
N2 - In the meta-analysis models, compared with cold steel dissection with ties/packs haemostasis (reference technique):Bipolar diathermy dissection and haemostasis was associated with statistically significant lower odds of primary haemorrhage (OR 0.13, 95% CrI 0.03 to 0.51), including primary haemorrhage requiring return to theatre (OR 0.002, 95% CrI < 0.001 to 0.26).Coblation was associated with statistically significant higher odds of secondary haemorrhage requiring return to theatre (OR 33.82, 95% CrI 1.25 to 5676.00).Monopolar and bipolar diathermy dissection and haemostasis (OR 4.12, 95% CrI 1.12 to 14.67; OR 2.86, 95% CrI 1.12 to 8.02, respectively), coblation (OR 3.75, 95% CrI 1.29 to 12.12), and cold steel dissection with monopolar or bipolar diathermy haemostasis (OR 4.83, 95% CrI 1.56 to 15.95; OR 9.18, 95% CrI 3.09 to 30.53, respectively) were all associated with statistically significant higher odds of secondary haemorrhage.In deciding which technique to employ, factors to consider include patient characteristics, the underlying risk of primary or secondary haemorrhage, which is regarded as likely to be more serious, and the clinical significance of the observed differences in haemorrhage rates across techniques.
AB - In the meta-analysis models, compared with cold steel dissection with ties/packs haemostasis (reference technique):Bipolar diathermy dissection and haemostasis was associated with statistically significant lower odds of primary haemorrhage (OR 0.13, 95% CrI 0.03 to 0.51), including primary haemorrhage requiring return to theatre (OR 0.002, 95% CrI < 0.001 to 0.26).Coblation was associated with statistically significant higher odds of secondary haemorrhage requiring return to theatre (OR 33.82, 95% CrI 1.25 to 5676.00).Monopolar and bipolar diathermy dissection and haemostasis (OR 4.12, 95% CrI 1.12 to 14.67; OR 2.86, 95% CrI 1.12 to 8.02, respectively), coblation (OR 3.75, 95% CrI 1.29 to 12.12), and cold steel dissection with monopolar or bipolar diathermy haemostasis (OR 4.83, 95% CrI 1.56 to 15.95; OR 9.18, 95% CrI 3.09 to 30.53, respectively) were all associated with statistically significant higher odds of secondary haemorrhage.In deciding which technique to employ, factors to consider include patient characteristics, the underlying risk of primary or secondary haemorrhage, which is regarded as likely to be more serious, and the clinical significance of the observed differences in haemorrhage rates across techniques.
KW - ELECTRODISSECTION TONSILLECTOMY
KW - HEMORRHAGE
U2 - 10.1111/j.1749-4486.2006.01162.x
DO - 10.1111/j.1749-4486.2006.01162.x
M3 - Article
SN - 0307-7772
VL - 31
SP - 95
EP - 102
JO - Clinical Otolaryngology and Allied Sciences
JF - Clinical Otolaryngology and Allied Sciences
IS - 2
ER -