Comparison of the Clinical Efficacy and Complications of Low-Temperature Plasma Tonsillectomy Versus Traditional Tonsillectomy: A Systematic Review and Meta-Analysis.

Abstract

Background: Low-temperature plasma tonsillectomy (LTPT) has emerged as a promising surgical technique for treating chronic tonsillitis (CT), offering advantages such as reduced postoperative pain, faster recovery, and decreased risk of bleeding compared with traditional tonsillectomy (TT). However, the comparative effectiveness and safety of LTPT remain under debate.

Objective: This study aimed to systematically evaluate the clinical outcomes and complication rates associated with LTPT versus TT in CT patients.

Methods: A comprehensive literature search was conducted across major databases, including Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, EMBASE, and the Cochrane Library, covering studies published between January 2010 and the present. Eight case-control studies comprising 654 patients were included. Data were analyzed using the RevMan 5.3 software, and risk of bias was assessed based on the Cochrane Handbook.

Results: Meta-analysis revealed that LTPT significantly reduced operation time (MD -12.4 minutes, 95% CI -15.2 to -9.6), intraoperative blood loss (MD -15.2 mL, 95% CI -20.1 to -10.3), and hospitalization duration (MD -0.7 days, 95% CI -1.0 to -0.4). LTPT was also associated with faster white membrane formation and lower postoperative visual analog scale scores. Inflammatory markers such as tumor necrosis factor-α (P = .002) and hypersensitivity C-reactive protein (P < .001) were significantly lower. Additionally, the complication rate in the LTPT group was markedly reduced (RR = 0.42, 95% CI 0.31 to 0.57; P < .001).

Conclusion: LTPT demonstrates superior perioperative outcomes and safety compared with TT in CT patients. Despite these benefits, further large-scale, high-quality studies are needed to confirm its long-term efficacy and guide clinical application.