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Systematic review of randomized controlled trials comparing intracapsular tonsillectomy with total tonsillectomy in a pediatric population.

Abstract

OBJECTIVE
To perform a systematic literature review and data synthesis of level-1 evidence comparing recovery-related outcomes after intracapsular tonsillectomy (IT) (any technique) with those of total tonsillectomy (TT) (any technique) in a pediatric population.
DATA SOURCES
Two independent reviewers searched the following databases: Ovid MEDLINE, including old MEDLINE and pre-MEDLINE, EBM reviews, Books@Ovid and Journals@Ovid, the Web of Science with Conference Proceedings, and references from indexed articles.
STUDY SELECTION
Inclusion criteria were randomized controlled trials conducted on a pediatric population comparing IT performed by any technique of dissection with TT, also performed by any technique of dissection. Two independent reviewers determined included trials with difference of opinion resolved by a third reviewer.
DATA EXTRACTION
Independent data extraction by 2 reviewers on the following outcomes: postoperative pain, analgesic use, recovery time, diet, bleeding rate, infection, and regrowth rate requiring further surgical intervention.
DATA SYNTHESIS
Heterogeneity of outcome measures and lack of reporting of raw data precluded formal meta-analysis. For quantitative data that could be extracted, pooled data analysis was performed using nonparametric tests.
CONCLUSION
Recovery-related outcomes for IT were superior to TT (secondary hemorrhage rate, number of days until pain free) in a pediatric population with obstructive symptoms (level-1 evidence).

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  • Authors

    Walton J, Ebner Y, Stewart MG, April MM

    Institution

    Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, England.

    Source

    Archives of otolaryngology--head & neck surgery 138:3 2012 Mar pg 243-9

    MeSH

    Analgesics
    Catheter Ablation
    Chi-Square Distribution
    Child
    Debridement
    Electrocoagulation
    Humans
    Laser Therapy
    Pain Measurement
    Pain, Postoperative
    Postoperative Hemorrhage
    Randomized Controlled Trials as Topic
    Statistics, Nonparametric
    Tonsillectomy
    Tonsillitis

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22431869