Microdebrider vs. electrocautery for tonsillectomy: a meta-analysis

Abstract

Objective: Tonsillectomy remains to be an ordinary operative process in otorhinolaryngology. Although there are a plenty of surgical means adopting in otorhinolaryngology, the advantage of one method over another has not been systematically demonstrated. The aim of designing this systematic review is to evaluate the efficiency of electrocautery tonsillectomy (ECT) compared with the microdebrider intracapsular tonsillotomy (MIT).

Methods: We retrieved randomized controlled trials (RCTs) from PubMed, EMBASE, Cochrane Library, CBM. Two reviewers extracted the information of included trials independently. The quality of included trials was assessed according to the criteria provided by Cochrane Handbook 5.0.1.

Results: Four researches were meeting the inclusive criteria which contained 501 participants, 253 in microdebrider tonsillotomy group and 248 in electrocautery tonsillectomy group. Systematic review illustrated that MT group had the recovery to normal activity and diet faster than ECT group [χ(2)=1.02, P<0.00001, 95% CI (-1.74, -1.30)] and [χ(2)=0.01, P<0.0001, 95% CI (-2.56, -0.92)]. There was a statistically significant in blood loss between microdebrider tonsillotomy and electrocautery tonsillectomy, the mean difference of 5.0 ml [P=0.01, 95% CI (3.4, 26.6)]. There was no statistical significance in surgical time.

Conclusions: Compared with the electrocautery tonsillectomy, microdebrider tonsillotomy could significantly speed up the time to return to normal activity and normal diet. Two groups were similar in terms of surgical time of tonsillectomy. This conclusion is needed to be further supported by large-scale, high-quality, placebo-controlled, double-blind trials between microdebrider tonsillotomy and other techniques in the surgery time and blood loss of operation.