Vessel Sealing System May Be Superior Tonsillectomy Method

Significantly shorter operative time, less bleeding and pain with vessel sealing system

TUESDAY, June 21 (HealthDay News) -- The vessel sealing system (VSS) may be a superior tonsillectomy method than other conventional or modern technology-assisted methods, according to a meta-analysis published in the June issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Vangelis G. Alexiou, M.D., from Northampton General Hospital in the United Kingdom, and colleagues reviewed the literature to assess evidence regarding modern technology-assisted tonsillectomy. Thirty-three randomized controlled trials including 3,139 patients compared total tonsillectomy performed using VSS, Harmonic Scalpel (HS), or radiofrequency ablation (Coblation) with the conventional technique of cold steel and/or electrocautery dissection (CS/EC). Outcome measures included operative time, perioperative and postoperative bleeding, and postoperative pain.

The investigators found that, compared to the CS/EC group, the VSS group had a significantly shorter operative time (weighted mean difference, −4.09 minutes), significantly less perioperative bleeding (standardized mean difference, −1.67), and postoperative bleeding (odds ratio, 0.28), and significantly less pain on the first and seventh postoperative days (standardized mean difference, −1.73 and −1.46, respectively). While there was significantly less perioperative bleeding in the HS group compared to the CS/EC group, other outcomes were not significantly different. There were no significant differences in any of the parameters in the Coblation and CS/EC treated groups.

"For tonsillectomies, the Coblation and HS techniques do not provide any significant advantage compared with CS/EC. Synthesis of the limited and heterogeneous data regarding VSSs showed a significant benefit in all studied outcomes," the authors write.

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