CO2 laser or dissection tonsillectomy: A systematic review and meta-analysis of clinical outcomes

• Published in: Auris, nasus, larynx nasus, larynx, 2023-02, Vol.50 (1), p.2-16
• Main Authors: Tsikopoulos, Alexios, Fountarlis, Athanasios, Tsikopoulos, Konstantinos, Dilmperis, Fotios, Tsikopoulos, Ioannis, Garefis, Konstantinos, Karkos, Petros, Skoulakis, Charalampos, Triaridis, Stefanos
• Format: Article
• Language: English
• Subjects: CO2 laser; Meta-analysis; Systematic review; Tonsillectomy
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2022.05.002

Recent evidence has suggested that performing a tonsillectomy with CO2 laser results in favorable intraoperative and postoperative outcomes. This study aimed to compare the clinical outcomes of CO2 and dissection tonsillectomy. We conducted a systematic search in PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL), until the 1st of September 2021 for completed studies comparing intraoperative and postoperative outcomes of CO2 laser and dissection tonsillectomy. Primary outcomes were operative time, intraoperative blood loss, and postoperative pain. Secondary outcomes included postoperative hemorrhage and tonsillar fossa healing. A random-effects pairwise meta-analysis of both randomized and non-randomized trials was performed. A subgroup analysis considering the randomization of trials was carried out, and sensitivity analyses linked to the quality of included papers or the age of patients were executed. Quality assessment was appraised with the Cochrane risk of bias and ROBINS-I tools for randomized and non-randomized trials, respectively. Eight trials with 632 cases contributed data to this review. For operative time, a significant difference in favor of CO2 laser tonsillectomy was documented (SMD = -1.32; 95% CI = -2.24 to -0.40; p