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<p>To compare the safety and efficacy of three tonsillectomy techniques—extracapsular bipolar radiofrequency ablation, intracapsular coblation tonsillotomy, and extracapsular cold steel dissection—by evaluating intraoperative blood loss, postoperative pain, recovery profile, and complication rates. A prospective, randomized clinical trial was conducted on 72 pediatric patients (age 5–18 years) undergoing tonsillectomy. Patients were equally allocated into three groups: Group A (extracapsular radiofrequency ablation), Group B (intracapsular coblation tonsillotomy), and Group C (cold steel tonsillectomy). Operative time, intraoperative blood loss, postoperative pain (visual analog scale), recovery parameters, and complications were assessed. Coblation achieved the shortest operative time (14.58 ± 2.04&#xa0;min) compared with radiofrequency (16.88 ± 1.92&#xa0;min) and cold steel (21.08 ± 2.59&#xa0;min; <i>p</i> &lt; 0.001). Intraoperative blood loss was lowest in the coblation group (4.75 ± 1.57&#xa0;ml), followed by radiofrequency (7.17 ± 1.88&#xa0;ml), and highest with cold steel (35.46 ± 10.46&#xa0;ml; <i>p</i> &lt; 0.001). Postoperative pain scores diverged significantly by week 1, with radiofrequency showing the highest pain levels, coblation intermediate, and cold steel the lowest (<i>p</i> &lt; 0.001). Recovery milestones were significantly delayed in the radiofrequency group compared with the other two groups (<i>p</i> &lt; 0.001). Bipolar radiofrequency ablation was associated with reduced intraoperative bleeding but greater postoperative pain and delayed recovery compared with coblation and cold steel tonsillectomy. Coblation offered advantages in operative efficiency, although its higher cost remains a limitation. Cold steel dissection provided comparable pain outcomes, but was associated with longer operative time and higher intraoperative bleeding.</p>

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Intracapsular Coblation Tonsillotomy Versus Extracapsular Radiofrequency and Cold Dissection Tonsillectomy: Results of a Randomized Clinical Trial

  • 期刊论文

  • 发表日期：

    2026年4月10日

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  • Saad Elzayat,
  • Ibrahim Gehad,
  • Ahmed Orabi,
  • Ahmed Elgendy

摘要

To compare the safety and efficacy of three tonsillectomy techniques—extracapsular bipolar radiofrequency ablation, intracapsular coblation tonsillotomy, and extracapsular cold steel dissection—by evaluating intraoperative blood loss, postoperative pain, recovery profile, and complication rates. A prospective, randomized clinical trial was conducted on 72 pediatric patients (age 5–18 years) undergoing tonsillectomy. Patients were equally allocated into three groups: Group A (extracapsular radiofrequency ablation), Group B (intracapsular coblation tonsillotomy), and Group C (cold steel tonsillectomy). Operative time, intraoperative blood loss, postoperative pain (visual analog scale), recovery parameters, and complications were assessed. Coblation achieved the shortest operative time (14.58 ± 2.04 min) compared with radiofrequency (16.88 ± 1.92 min) and cold steel (21.08 ± 2.59 min; p < 0.001). Intraoperative blood loss was lowest in the coblation group (4.75 ± 1.57 ml), followed by radiofrequency (7.17 ± 1.88 ml), and highest with cold steel (35.46 ± 10.46 ml; p < 0.001). Postoperative pain scores diverged significantly by week 1, with radiofrequency showing the highest pain levels, coblation intermediate, and cold steel the lowest (p < 0.001). Recovery milestones were significantly delayed in the radiofrequency group compared with the other two groups (p < 0.001). Bipolar radiofrequency ablation was associated with reduced intraoperative bleeding but greater postoperative pain and delayed recovery compared with coblation and cold steel tonsillectomy. Coblation offered advantages in operative efficiency, although its higher cost remains a limitation. Cold steel dissection provided comparable pain outcomes, but was associated with longer operative time and higher intraoperative bleeding.