The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis

Ho Seok Lee; Ho Young Yoon; Ho Joon Jin; Se Hwan Hwang

doi:10.1002/lary.26886

The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis

Ho Seok Lee
, Ho Young Yoon
, Ho Joon Jin
, Se Hwan Hwang

Department of Otorhinolaryngology

The Catholic University of Korea

Research output: Contribution to journal › Review article › peer-review

40 Scopus citations

Abstract

Objectives: We performed a systemic review and meta-analysis regarding the postoperative pain, perioperative, and postoperative morbidity of powered intracapsular tonsillectomy and adenoidectomy (PITA) using a microdebrider as a method of tonsillectomy. Data Sources: Five databases (PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials) in their entirety through March 2017. Review Methods: We included studies in which there was a comparison between groups of patients who underwent PITA (PITA group) and those who had extracapsular tonsillectomy (control group). Articles assessing effects of PITA in the pediatric patient were systemically and independently reviewed by two researchers. The outcomes of interest were intraoperative morbidity (operative time and bleeding), postoperative morbidity (postoperative pain, recovery time, tonsil regrowth, and postoperative bleeding rate), and improvement of sleep breath disorder (apnea-hypopnea index [AHI] and symptomatic scores). Results: PITA did not significantly increase operative time or intraoperative blood loss. With PITA, there was significantly decreased postoperative pain, amount of analgesia, time to resumption of normal diet and activity, and incidence of postoperative admissions (due to dehydration or postoperative bleeding control) compared to those of the control group. In contrast, the incidence of postoperative tonsil regrowth was statistically higher in the PITA group than in the control group. The PITA improved AHI and obstructive sleep apnea 18-item questionnaire scores significantly, which were similar with the control group. Conclusions: With regard to intraoperative morbidity and postoperative morbidity, PITA is a safe procedure. However, there are high levels of heterogeneity with regard to several measured parameters. Therefore, further large, well-designed trials are required to substantiate our findings. Laryngoscope, 128:732–744, 2018.

Original language	English
Pages (from-to)	732-744
Number of pages	13
Journal	Laryngoscope
Volume	128
Issue number	3
DOIs	https://doi.org/10.1002/lary.26886
State	Published - Mar 2018

Bibliographical note

Publisher Copyright:
© 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Keywords

Tonsillectomy
and morbidity
microdebrider
pediatric

Access to Document

10.1002/lary.26886

Cite this

@article{9d61c1de4f6e4eaa998719b23a46f905,

title = "The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis",

abstract = "Objectives: We performed a systemic review and meta-analysis regarding the postoperative pain, perioperative, and postoperative morbidity of powered intracapsular tonsillectomy and adenoidectomy (PITA) using a microdebrider as a method of tonsillectomy. Data Sources: Five databases (PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials) in their entirety through March 2017. Review Methods: We included studies in which there was a comparison between groups of patients who underwent PITA (PITA group) and those who had extracapsular tonsillectomy (control group). Articles assessing effects of PITA in the pediatric patient were systemically and independently reviewed by two researchers. The outcomes of interest were intraoperative morbidity (operative time and bleeding), postoperative morbidity (postoperative pain, recovery time, tonsil regrowth, and postoperative bleeding rate), and improvement of sleep breath disorder (apnea-hypopnea index [AHI] and symptomatic scores). Results: PITA did not significantly increase operative time or intraoperative blood loss. With PITA, there was significantly decreased postoperative pain, amount of analgesia, time to resumption of normal diet and activity, and incidence of postoperative admissions (due to dehydration or postoperative bleeding control) compared to those of the control group. In contrast, the incidence of postoperative tonsil regrowth was statistically higher in the PITA group than in the control group. The PITA improved AHI and obstructive sleep apnea 18-item questionnaire scores significantly, which were similar with the control group. Conclusions: With regard to intraoperative morbidity and postoperative morbidity, PITA is a safe procedure. However, there are high levels of heterogeneity with regard to several measured parameters. Therefore, further large, well-designed trials are required to substantiate our findings. Laryngoscope, 128:732–744, 2018.",

keywords = "Tonsillectomy, and morbidity, microdebrider, pediatric",

author = "Lee, \{Ho Seok\} and Yoon, \{Ho Young\} and Jin, \{Ho Joon\} and Hwang, \{Se Hwan\}",

note = "Publisher Copyright: {\textcopyright} 2017 The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2018",

month = mar,

doi = "10.1002/lary.26886",

language = "English",

volume = "128",

pages = "732--744",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "Wiley-Blackwell",

number = "3",

}

TY - JOUR

T1 - The safety and efficacy of powered intracapsular tonsillectomy in children

T2 - A meta-analysis

AU - Lee, Ho Seok

AU - Yoon, Ho Young

AU - Jin, Ho Joon

AU - Hwang, Se Hwan

PY - 2018/3

Y1 - 2018/3

N2 - Objectives: We performed a systemic review and meta-analysis regarding the postoperative pain, perioperative, and postoperative morbidity of powered intracapsular tonsillectomy and adenoidectomy (PITA) using a microdebrider as a method of tonsillectomy. Data Sources: Five databases (PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials) in their entirety through March 2017. Review Methods: We included studies in which there was a comparison between groups of patients who underwent PITA (PITA group) and those who had extracapsular tonsillectomy (control group). Articles assessing effects of PITA in the pediatric patient were systemically and independently reviewed by two researchers. The outcomes of interest were intraoperative morbidity (operative time and bleeding), postoperative morbidity (postoperative pain, recovery time, tonsil regrowth, and postoperative bleeding rate), and improvement of sleep breath disorder (apnea-hypopnea index [AHI] and symptomatic scores). Results: PITA did not significantly increase operative time or intraoperative blood loss. With PITA, there was significantly decreased postoperative pain, amount of analgesia, time to resumption of normal diet and activity, and incidence of postoperative admissions (due to dehydration or postoperative bleeding control) compared to those of the control group. In contrast, the incidence of postoperative tonsil regrowth was statistically higher in the PITA group than in the control group. The PITA improved AHI and obstructive sleep apnea 18-item questionnaire scores significantly, which were similar with the control group. Conclusions: With regard to intraoperative morbidity and postoperative morbidity, PITA is a safe procedure. However, there are high levels of heterogeneity with regard to several measured parameters. Therefore, further large, well-designed trials are required to substantiate our findings. Laryngoscope, 128:732–744, 2018.

AB - Objectives: We performed a systemic review and meta-analysis regarding the postoperative pain, perioperative, and postoperative morbidity of powered intracapsular tonsillectomy and adenoidectomy (PITA) using a microdebrider as a method of tonsillectomy. Data Sources: Five databases (PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials) in their entirety through March 2017. Review Methods: We included studies in which there was a comparison between groups of patients who underwent PITA (PITA group) and those who had extracapsular tonsillectomy (control group). Articles assessing effects of PITA in the pediatric patient were systemically and independently reviewed by two researchers. The outcomes of interest were intraoperative morbidity (operative time and bleeding), postoperative morbidity (postoperative pain, recovery time, tonsil regrowth, and postoperative bleeding rate), and improvement of sleep breath disorder (apnea-hypopnea index [AHI] and symptomatic scores). Results: PITA did not significantly increase operative time or intraoperative blood loss. With PITA, there was significantly decreased postoperative pain, amount of analgesia, time to resumption of normal diet and activity, and incidence of postoperative admissions (due to dehydration or postoperative bleeding control) compared to those of the control group. In contrast, the incidence of postoperative tonsil regrowth was statistically higher in the PITA group than in the control group. The PITA improved AHI and obstructive sleep apnea 18-item questionnaire scores significantly, which were similar with the control group. Conclusions: With regard to intraoperative morbidity and postoperative morbidity, PITA is a safe procedure. However, there are high levels of heterogeneity with regard to several measured parameters. Therefore, further large, well-designed trials are required to substantiate our findings. Laryngoscope, 128:732–744, 2018.

KW - Tonsillectomy

KW - and morbidity

KW - microdebrider

KW - pediatric

UR - https://www.scopus.com/pages/publications/85032192240

U2 - 10.1002/lary.26886

DO - 10.1002/lary.26886

M3 - Review article

C2 - 29068049

AN - SCOPUS:85032192240

SN - 0023-852X

VL - 128

SP - 732

EP - 744

JO - Laryngoscope

JF - Laryngoscope

IS - 3

ER -

The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this