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Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis
Ya-Lei Sun1, Bin Yuan1, Fei Kong1
1Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
The Annals of Otology, Rhinology, and Laryngology
|March 1, 2022
Summary
Network meta-analysis found no significant differences in operative time, blood loss, or residual tissue among four adenoidectomy techniques. Plasma field ablation adenoidectomy showed lower postoperative pain than curettage.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Adenoidectomy is a common otolaryngologic procedure.
- Current guidelines lack specificity for choosing surgical approaches.
- A need exists for evidence-based recommendations.
Purpose of the Study:
- To conduct a network meta-analysis (NMA) of adenoidectomy techniques.
- To compare powered vacuum shaver adenoidectomy (PVSA), plasma field ablation adenoidectomy (PFAA), curettage adenoidectomy (CUA), and suction diathermy adenoidectomy (SDA).
- To evaluate operative time, blood loss, postoperative pain, and residual tissue.
Main Methods:
- Systematic literature search of Cochrane, PubMed, and EMBASE databases up to July 31, 2021.
- Network meta-analysis of 20 studies involving 2329 patients.
- Comparison of four surgical approaches based on key outcomes.
Main Results:
- No significant differences found between PVSA, PFAA, CUA, and SDA for operative time, intraoperative blood loss, or residual tissue incidence.
- Plasma field ablation adenoidectomy (PFAA) demonstrated significantly lower postoperative pain scores compared to curettage adenoidectomy (CUA).
- No other significant differences in postoperative pain were observed among the remaining surgical approaches.
Conclusions:
- No single adenoidectomy technique demonstrated superiority in terms of operative time, blood loss, or residual tissue.
- Plasma field ablation adenoidectomy (PFAA) offers a potential advantage in reducing postoperative pain compared to curettage adenoidectomy (CUA).
- Further research may refine guidelines for surgical approach selection in adenoidectomy.
