Efficacy and safety of coblation-assisted partial tonsillectomy in the treatment of pediatric OSAHS:a Meta-analysis
Liu Ruihong
Peng Tao
Abstract：Objective To analyze the clinical efficacy and safety of tonsillotomy(TT)assisted by coblation compared to ton-sillectomy(TE)in the treatment of pediatric obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The PubMed,Embase,Cochrane Library,Web of Science,Medline,China National Knowledge Infrastructure(CNKI),Wan-fang,and VIP databases were systematically searched from the establishment of the databases to October 2022.Randomized controlled trials(RCTs)and case-control studies on the clinical efficacy of coblation-assisted TT and TE in treating pediatric OSAHS were included.The included literature was evaluated for methodological quality,and a meta-analysis was performed using RevMan 5.4 software for studies that met the quality criteria.Results A total of 23 studies,involving 2 242 children who underwent TT and 2 381 children who underwent TE,were finally included.The meta-analysis results showed that the TT group had significant advantages over the TE group in terms of operation time(MD=-6.12,95％CI:-7.93 to-4.32,P＜0.001),intraoperative blood loss(MD=-5.54,95％CI:-6.91 to-4.17,P＜0.001),average length of hospital stay(MD=-2.46,95％CI:-2.97 to-1.95,P＜0.001),postoperative 24-hour visual analog scale(VAS)pain score(MD=-1.48,95％CI:-2.07 to-0.89,P＜0.001),postoperative 72-hour VAS(MD=-1.34,95％CI:-2.46 to-0.22,P=0.020),secondary bleeding(RR=0.22,95％CI:0.13 to 0.38,P＜0.001),and postoperative pharyngeal lymphoid hyperplasia(RR=0.15,95％CI:0.06 to 0.38,P＜0.001).No statistical significance was found be-tween the two groups in terms of the difference in preoperative and postoperative apnea-hypopnea index(AHI)(MD=0.44,95％CI:-0.35 to 1.22,P=0.270),the difference in preoperative and postoperative minimum oxygen saturation(MD=0.28,95％CI:-0.12 to 0.68,P=0.160),and postoperative fever(RR=0.86,95％CI:0.35 to 2.15,P=0.750).Conclusion Coblation-assisted TT can effectively reduce operation time,intraoperative bleeding,length of hospital stay,and postoperative VAS score,as well as the incidence of postoperative complications such as secondary bleeding and pharyngeal lymphoid tissue hyperplasia,with its efficacy comparable to TE.
Keywords：Coblation-assisted tonsillectomyCoblation-assisted partial tonsillotomyPediatric obstructive sleep apnea-hy-popnea syndromeMeta-analysis
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 56-64 )