Thulium laser versus coblation tonsillectomy: an experimental comparison of efficacy

To compare the effects of thulium laser (TmLR) versus low-temperature plasma radiofrequency ablation (COBLATION) on perioperative parameters, serum inflammatory factors, and postoperative healing following tonsillectomy in New Zealand rabbits. Twenty-four rabbits were randomly selected. The left tonsil underwent TmLR, while the right underwent COBLATION. Postoperative wound healing on both sides was compared. Another twenty-four rabbits were randomly divided into two groups, undergoing bilateral tonsillectomy using either TmLR or COBLATION. Surgical duration, intraoperative blood loss, postoperative water intake, weight changes, postoperative inflammatory factor levels, and pathological analysis of the fibrin membrane covering the wound were compared between the two groups. The TmLR group had significantly shorter surgical duration and less intraoperative blood loss than the COBLATION group (P < 0.05). Postoperative water intake was significantly higher in the TmLR group (P < 0.05). Weight loss was significantly less in the TmLR group (P < 0.05). Endoscopic examination at 4 h post-surgery revealed better wound conditions in the TmLR group. However, at postoperative days 1, 3, and 5, the COBLATION side showed better recovery, with statistically significant differences in wound scores (P < 0.05). By postoperative day 7, both sides recovered well with no significant histological differences between groups (P > 0.05). Hematological analysis revealed no statistically significant differences in inflammatory factor levels between the two groups. Pathological analysis indicated a more pronounced inflammatory reaction in the TmLR group at day 3 compared to COBLATION. By day 7, the pathological manifestations were similar in both groups. Thulium laser tonsillectomy offers advantages in terms of shorter surgical time, reduced intraoperative bleeding, and potentially lower postoperative pain (as inferred by higher water intake and less weight loss). There was no statistically significant difference in overall efficacy between the thulium fiber laser system and the low-temperature plasma system. The thulium laser can be considered a viable alternative instrument for tonsillectomy.