Sunnergren Ola, Odhagen Erik, Stalfors Joacim
Department of Otorhinolaryngology, Ryhov County Hospital, County Council Jönköping, 551 85, Jönköping, Sweden.
Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Borås, Sweden.
Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2945-2951. doi: 10.1007/s00405-017-4543-6. Epub 2017 Mar 23.
The aim of the study is to evaluate the incidence and risk factors of a second surgery of the adenoids or tonsils for hypertrophy in children who have already undergone surgery for the same condition. This is a retrospective study (2004-2013) based on data from the National patient registry in Sweden. A total of 41,401 children underwent a first surgery of the adenoids or tonsils during the studied period. The most commonly performed (first) surgical procedure was adenoidectomy followed by adenotonsillotomy, adenotonsillectomy, tonsillotomy, and tonsillectomy. A total of 4459 patients underwent a second surgery for the same condition. The incidence of a second surgery was the highest in the primary adenoidectomy group (72.2, 95% CI 69.7-74.7) and lowest in the primary adenotonsillectomy group (14.2, 95% CI 12.6-15.9). A lower age at first surgery significantly increased the risk for a second surgery. A second surgery of the adenoids and tonsils due to lymphoid hypertrophy was common in the pediatric population. Adenoidectomy stands out in a negative way in most aspects of this study compared to the other types of first surgery. However, due to the design of this study, the results of this study cannot be taken as proof of a full adenotonsillectomy as the most appropriate first surgery in children with lymphoid upper airway obstruction. Nevertheless, the results clearly show that the topic needs to be addressed in future studies.
本研究的目的是评估已经因腺样体或扁桃体肥大接受过手术的儿童再次进行腺样体或扁桃体手术的发生率及风险因素。这是一项基于瑞典国家患者登记处数据的回顾性研究（2004 - 2013年）。在研究期间，共有41401名儿童接受了首次腺样体或扁桃体手术。最常施行的（首次）手术操作是腺样体切除术，其次是腺样体扁桃体切开术、腺样体扁桃体切除术、扁桃体切开术和扁桃体切除术。共有4459名患者因相同病情接受了二次手术。二次手术的发生率在初次腺样体切除组中最高（72.2，95%可信区间69.7 - 74.7），在初次腺样体扁桃体切除组中最低（14.2，95%可信区间12.6 - 15.9）。首次手术时年龄较小显著增加了二次手术的风险。在儿科人群中，因淋巴样组织肥大进行的腺样体和扁桃体二次手术很常见。在本研究的大多数方面，与其他类型的首次手术相比，腺样体切除术呈现出负面特征。然而，由于本研究的设计，本研究结果不能作为全腺样体扁桃体切除术是淋巴样上气道阻塞儿童最合适的首次手术的证据。尽管如此，结果清楚地表明该主题需要在未来的研究中加以探讨。
