Comparison of Postoperative Secondary Haemorrhage Rates and Pain Threshold between Conventional Cold Dissection, Bipolar, Monopolar Electrocautery and Laser Tonsillectomy, Meta Analysis Study

Abstract

Abstract Background Tonsil surgery is one of the most common surgical procedures performed in otorhinolaryngology. The earliest known removal of tonsils was performed by Celsius in the first century A.D. Aim of the Work To compare the postoperative secondary haemorrhage rates and pain threshold between conventional cold dissection, bipolar, monopolar electrocautery and laser tonsillectomy. Patients and Methods This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. An initial search will be carried out using the PubMed, Cochrane library Ovid, Scopus & Google scholar using the following keywords: Dissection, Diathermy, Laser electrocautery, Tonsillectomy. Results Highly significant decrease in mean 7-day post-operative pain score, in conventional dissection group compared to diathermy group (p < 0.01). Significant decrease in mean 7-day post-operative pain score, in conventional dissection group compared to laser electrocautery group (p = 0.024). Nonsignificant difference in mean 7-day post-operative pain score, in diathermy group compared to laser electrocautery group (p > 0.05). Non-significant difference in revision or re-operation rate, in conventional dissection group compared to diathermy group (p > 0.05). Non-significant difference in secondary haemorrhage rate, in conventional dissection group compared to diathermy group (p > 0.05). Non-significant difference in secondary haemorrhage rate, in conventional dissection group compared to laser electrocautery group (p > 0.05). Conclusion Based on the findings of the present study, all the methods used in the study are safe but there was significant decrease in mean 7-day post-operative pain score using conventional dissection method compared to diathermy and laser electrocautery methods with no difference found in secondary haemorrhage rates between different methods used.