Thomas Konstanze, Boeger Daniel, Buentzel Jens, Esser Dirk, Hoffmann Kerstin, Jecker Peter, Mueller Andreas, Radtke Gerald, Geißler Katharina, Finkensieper Mira, Guntinas-Lichius Orlando
Department of Otorhinolaryngology, Jena University Hospital, Germany.
Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1716-20. doi: 10.1016/j.ijporl.2013.07.032. Epub 2013 Aug 14.
To evaluate population-based data on incidence of pediatric adenoidectomy and rate of revision surgery.
A retrospective study of all adenoidectomies in children was performed in the year 2009 in all otolaryngology departments in one federal state, Thuringia, in Germany. Patients' characteristics, preoperative diagnostics and postoperative complications were analyzed. The association between baseline characteristics and the risk of re-adenoidectomy was examined using Kaplan-Meier method with univariate log-rank test, and with a multivariate Cox regression model. Population data were used to calculate age-related annual rates of adenoidectomies.
1939 adenoidectomies were performed in 2009 in Thuringia. 89% were primary cases and 11% of the children already had an adenoidectomy prior to 2009. Immediate re-surgery because of primary hemorrhage was necessary in 0.8% of the cases. Re-adenoidectomy because of recurrent symptoms was needed in 9% of patients after a median interval of 16 months. The univariate analysis showed that the factors age ≤3 years and primary surgery were significantly associated to a higher risk of surgery because of recurrent symptoms The multivariate analysis showed that primary surgery was independently associated with the risk of re-surgery (hazard ratio 1.66; 95% confidence interval 1.01-2.74). The annual adenoidectomy rate was 678/100,000 underage habitants. The incidence was highest between 2 and 4 years of age.
This population based analysis is showing that adenoidectomy is performed country-wide with good results and low risk on important scale in daily routine by otorhinolaryngologists. The risk of re-adenoidectomy seems to be higher than hitherto reported by hospital-based studies.
评估基于人群的小儿腺样体切除术发病率及再次手术率数据。
对德国图林根州一个联邦州所有耳鼻喉科在2009年进行的所有小儿腺样体切除术进行回顾性研究。分析患者特征、术前诊断和术后并发症。采用Kaplan-Meier方法和单因素对数秩检验以及多因素Cox回归模型，研究基线特征与再次腺样体切除术风险之间的关联。利用人群数据计算与年龄相关的腺样体切除术年发生率。
2009年图林根州进行了1939例腺样体切除术。89%为初次手术病例，11%的儿童在2009年之前已经接受过腺样体切除术。0.8%的病例因原发性出血需要立即再次手术。9%的患者在中位间隔16个月后因复发症状需要再次腺样体切除术。单因素分析显示，年龄≤3岁和初次手术这两个因素与因复发症状进行手术的较高风险显著相关。多因素分析显示，初次手术与再次手术风险独立相关（风险比1.66；95%置信区间1.01-2.74）。腺样体切除术年发生率为每10万未成年居民678例。发病率在2至4岁之间最高。
这项基于人群的分析表明，耳鼻喉科医生在日常工作中在全国范围内进行腺样体切除术，效果良好且风险较低。再次腺样体切除术的风险似乎比以往基于医院的研究所报告的要高。
