Muninnobpamasa Tarit, Khamproh Kanyarat, Moungthong Greetha
Department of Otolaryngology, Phramongkutklao College of Medicine, Bangkok, Thailand.
J Med Assoc Thai. 2012 May;95 Suppl 5:S69-74.
Tonsillectomy and adenoidectomy, one of the major procedures among otolaryngologist, may have risk in post operative complications which can be either non severe complications (dysphagia, wound pain, dehydration) or serious complications (Bleeding, partial airway obstruction). Meticulous attention to surgical techniques and technical advance in anesthesiology have significantly reduced the number of complications. In Thailand, there are few reports about the adenotonsillectomy complications so the objectives of the present study were to determine the prevalence and related risk factors in patients visiting the department of Otolaryngology, Phramongkutklao Hospital.
To determine the prevalence ofcomplications and related risk factors in patients who underwent adenotonsillectomy in Phramongkutklao Hospital.
The patients who had undergone adenotonsillectomy from January 2003 to December 2006 in the department of Otolaryngology, Phramongkutklao Hospital was retrospectively and prospectively reviewed. Information extracted included age, tonsillar size, indication for surgery, the post operative complications (anesthetic complication, primary bleeding, secondary bleeding, airway obstruction, dysphagia, wound pain, dehydration, length of stay in hospital and re-admission.
Four hundred and eighty-one patients were enrolled, of which 36.8% were younger than 12 years-old and 63.2% were over 12 years-old; 39.3% male and 60.7% female. Indication for surgery provided by chronic hypertrophic tonsillitis 73%, obstructive sleep apnea 23.5%, peritonsillar abscess and others 3.5%. The prevalence of complications was anesthetic complication 1.6%, primary bleeding 4.1%, secondary bleeding 3.9%, dysphagia 29.0%, dehydration 4.6%, wound pain 48.1%. The average length of hospital stay was 3.6 days and re-admission 3.7%.
The prevalence of post operative complication after tonsillectomy and adenoidectomy was low but higher than other previous studies included the primary bleeding and secondary bleeding.
扁桃体切除术和腺样体切除术是耳鼻喉科医生进行的主要手术之一，术后可能会出现并发症风险，这些并发症可以是不严重的并发症（吞咽困难、伤口疼痛、脱水）或严重并发症（出血、部分气道阻塞）。对手术技术的细致关注和麻醉学的技术进步已显著减少了并发症的数量。在泰国，关于腺样体扁桃体切除术并发症的报道很少，因此本研究的目的是确定在佛统府医院耳鼻喉科就诊患者的并发症发生率及相关危险因素。
确定在佛统府医院接受腺样体扁桃体切除术患者的并发症发生率及相关危险因素。
对2003年1月至2006年12月在佛统府医院耳鼻喉科接受腺样体扁桃体切除术的患者进行回顾性和前瞻性研究。提取的信息包括年龄、扁桃体大小、手术指征、术后并发症（麻醉并发症、原发性出血、继发性出血、气道阻塞、吞咽困难、伤口疼痛、脱水、住院时间和再次入院情况）。
共纳入481例患者，其中36.8%年龄小于12岁，63.2%年龄大于12岁；男性占39.3%，女性占60.7%。手术指征为慢性肥厚性扁桃体炎的占73%，阻塞性睡眠呼吸暂停的占23.5%，扁桃体周围脓肿及其他情况的占3.5%。并发症发生率为麻醉并发症1.6%，原发性出血4.1%，继发性出血3.9%，吞咽困难29.0%，脱水4.6%，伤口疼痛48.1%。平均住院时间为3.6天，再次入院率为3.7%。
扁桃体切除术和腺样体切除术后的术后并发症发生率较低，但高于以往其他研究，包括原发性出血和继发性出血。
