Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Otolaryngol Head Neck Surg. 2012 May;146(5):752-6. doi: 10.1177/0194599812437317. Epub 2012 Feb 14.
To evaluate the safety of tonsillectomy in a short-term medical mission setting.
Retrospective chart review.
Catholic mission hospital in Guatemala.
During 7 consecutive annual mission trips from 2004 to 2010, patients received tonsillectomy and adenotonsillectomy. Established safety protocol requires candidates for tonsillectomy to agree to stay within 1 hour of the hospital for 10 days following the operation. This study includes all tonsillectomy patients regardless of age or indication for tonsillectomy. The primary outcome measures include posttonsillectomy hemorrhage, nasopharyngeal reflux, readmission for dehydration, and mortality. This is a novel study as the work performed by most short-term medical missions is unregulated and unevaluated.
Medical charts were available for 197 (96.6%) of the 204 patients receiving tonsillectomy in the 7-year period; this was the only inclusion criterion. Ninety-nine (50.3%) patients had tonsillectomy concomitantly with adenoidectomy. Patients ranged in age from 3 to 66 years. The mean (SD) age was 17.2 (14.0) years. The study team found documentation of postoperative complications in 3 (1.5%) patients; 2 experienced postoperative hemorrhage, 1 within the first postoperative hour and 1 at 96 hours. The final patient returned to the hospital within 24 hours symptomatic for dehydration.
The authors have evaluated a protocol for tonsillectomy patients in a specific setting and believe their data represent satisfactory outcomes for the reviewed patients. The generalizability of this information is uncertain, but safety protocols should be established on all short-term medical missions to prevent untoward complications.
评估在短期医疗任务环境中进行扁桃体切除术的安全性。
回顾性病历审查。
危地马拉的天主教传教士医院。
在 2004 年至 2010 年的 7 次连续年度任务中，患者接受了扁桃体切除术和腺样体切除术。既定的安全协议要求扁桃体切除术候选人同意在手术后 10 天内留在医院 1 小时内。本研究包括所有扁桃体切除术患者，无论年龄或扁桃体切除术的适应证如何。主要观察指标包括扁桃体切除术后出血、鼻咽反流、因脱水再入院和死亡率。这是一项新颖的研究，因为大多数短期医疗任务的工作不受监管和评估。
在 7 年期间，共有 204 名接受扁桃体切除术的患者中有 197 名（96.6%）的病历可用；这是唯一的纳入标准。99 名（50.3%）患者同时接受了扁桃体切除术和腺样体切除术。患者年龄从 3 岁到 66 岁不等。平均（SD）年龄为 17.2（14.0）岁。研究小组发现 3 名（1.5%）患者有术后并发症的记录；2 例发生术后出血，1 例在术后第 1 小时内，1 例在术后第 96 小时内。最后一名患者在出现脱水症状后 24 小时内返回医院。
作者评估了特定环境中扁桃体切除术患者的方案，并认为他们的数据代表了所审查患者的满意结果。该信息的普遍性尚不确定，但应在所有短期医疗任务中建立安全方案，以防止不良并发症。
