Systematic review of the safety of electrosurgery for tonsillectomy

Graham Mowatt, Jonathan Alistair Cook, Cynthia Mary Fraser, W. S. McKerrow, Jennifer Margaret Burr

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34 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)95-102
Number of pages7
JournalClinical Otolaryngology and Allied Sciences
Volume31
Issue number2
DOIs
Publication statusPublished - Apr 2006

Keywords

  • ELECTRODISSECTION TONSILLECTOMY
  • HEMORRHAGE

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