- Design
- Retrospective single-centre case series
- Population
- 1,734 children having intracapsular tonsillotomy with adenoidectomy
- Primary outcome
- Postoperative bleeding and revision surgery
- Effect
- Bleeding 1% vs 0.9%, OR 1.1 (0.35–3.47); revision 0.5% vs 1%, OR 0.85 (0.23–3.15)
This retrospective case series from one children's hospital, published on 29 September, compared 385 intracapsular tonsillotomies with adenoidectomy done by coblation (2 surgeons) with 1,349 done by microdebrider (13 surgeons) between 2018 and 2024. Mean age was about five.
Coblation was two minutes quicker (median 22 vs 24 minutes). Postoperative bleeding (1% vs 0.9%) and revision surgery (0.5% vs 1%) did not differ significantly, though the confidence intervals were wide. Younger children were more likely to need revision.
Both techniques look safe in experienced hands, and the choice can rest on equipment, cost and surgeon familiarity. The finding worth passing to parents is that regrowth needing revision was more likely the younger the child.
- Choose between coblation and microdebrider on equipment, cost and experience; outcomes were similar.
- Counsel parents of younger children that revision for regrowth is more likely.
- Expect bleeding rates around 1% after intracapsular surgery in this series.
- Audit your own bleeding and revision rates by technique.
Why it matters
The device matters less than the child's age when it comes to needing a second operation.
Don't overread it
Few events and very unequal surgeon numbers per technique make the comparison imprecise.
The statistics, in plain English
An odds ratio of 1.1 for bleeding with an interval from 0.35 to 3.47 means the data are compatible with coblation being much safer or much riskier; bleeding was too rare to tell.
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