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Published on: November 6, 2019
Electrocautery adenoidectomy outcomes: a meta-analysis
Jeremy Reed1, Shankar Sridhara, Scott E Brietzke
1Department of Otolaryngology, Walter Reed Army Medical Center, Washington, DC, USA.
Objective:
Review the published literature regarding clinical outcomes of suction electrocautery adenoidectomy (ECA) in pediatric patients.
Data Source:
The MEDLINE database was systematically reviewed for articles reporting on the use of ECA.
Review Methods:
Each study was independently reviewed by each investigator. Inclusion criteria included English language, sample size greater than five, and presentation of extractable data regarding outcomes with ECA. Random-effects modeling was used to estimate summary outcomes.
Results:
Nine studies met the inclusion criteria. The mean sample size was 276 patients with a grand mean age of 6.0 years. Random-effects modeling of intraoperative hemorrhage (4.1 cc vs 24.0 cc, 95 percent CI of difference = 16.5-23.1, P < 0.001) and operative time (10.0 minutes vs 18.4 minutes, 95 percent CI of difference = 0.82-2.90, P < 0.001) favored ECA vs curette adenoidectomy. Subjective success was reported in 95.0 percent (95% CI = 92.7%-97.3%, P < 0.001) of ECA patients with a grand mean of 5.8 months of follow-up. Adenoid regrowth was evaluated objectively (endoscopy or x ray) in only 116 of 2132 patients (5.4%), with an observed regrowth rate of 2.8 percent that (95% CI = 0%-5.5%, P = 0.052).
Conclusions:
The preponderance of available evidence favors ECA vs curette adenoidectomy in terms of decreased intraoperative hemorrhage and operative time. Long-term outcome data for ECA are scarce but suggest a low regrowth and complication rate.
