Alvo Andrés, Hall Andrew, Johnston James, Mahadevan Murali
Department of Paediatric Otorhinolaryngology, Starship Children's Hospital, Auckland, New Zealand.
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Int J Otolaryngol. 2019 Mar 6;2019:4101034. doi: 10.1155/2019/4101034. eCollection 2019.
Tonsillectomy is one of the most commonly performed surgical procedures in children. It is performed for sleep-disordered breathing and infective symptoms. Despite advances in instrumentation and perioperative care, posttonsillectomy haemorrhage (PTH) remains a significant complication, which should be audited regularly.
A retrospective case series of all tonsillectomies performed in patients <15 years old in the Auckland region during 2017 was performed. Demographic, clinical, and surgical data were extracted and analysed. Univariate analysis was performed to compare patients with and without PTH.
A total of 2177 tonsillectomies were performed during the study period, 64% in a public hospital and 36% in a private hospital. The overall PTH rate was 3.6% (0.23% occurring within the first 24 hours (primary) and 3.4% after 24 hours (secondary)). Mean time to PTH was 6.6 ± 3 days (range: 1-16 days). 90% of PTH occurred within the first 10 days and 99% by 14 days. Return to theatre was required in 28% of these cases, representing 1% of all tonsillectomies. There were no deaths or major complications in this cohort. The only differences observed between patients with PTH and those without were that children with PTH had smaller tonsils (=0.004) and were less likely to have associated OME (<0.001).
It is important to report institutional tonsillectomy outcomes and associated complications. These results show that PTH rates in Auckland remain within acceptable limits according to the literature.
扁桃体切除术是儿童中最常进行的外科手术之一。该手术用于治疗睡眠呼吸障碍和感染症状。尽管手术器械和围手术期护理有所进步，但扁桃体切除术后出血（PTH）仍然是一种严重的并发症，应定期进行审核。
对2017年奥克兰地区15岁以下患者进行的所有扁桃体切除术进行回顾性病例系列研究。提取并分析人口统计学、临床和手术数据。进行单因素分析以比较有和没有PTH的患者。
在研究期间共进行了2177例扁桃体切除术，64%在公立医院进行，36%在私立医院进行。总体PTH发生率为3.6%（0.23%发生在术后24小时内（原发性），3.4%发生在24小时后（继发性））。PTH的平均发生时间为6.6±3天（范围：1 - 16天）。90%的PTH发生在头10天内，99%在14天内发生。其中28%的病例需要返回手术室，占所有扁桃体切除术的1%。该队列中无死亡或重大并发症。PTH患者与非PTH患者之间观察到的唯一差异是，PTH患儿的扁桃体较小（P = 0.004），且合并分泌性中耳炎（OME）的可能性较小（P < 0.001）。
报告机构扁桃体切除术的结果及相关并发症很重要。这些结果表明，根据文献，奥克兰的PTH发生率仍在可接受范围内。
