Medical Intern, College of Medicine, Taif University, Taif City, Saudi Arabia.
Senior Registrar ORL Head and Neck Surgery, King Abdulaziz Specialist Hospital, Taif City, Saudi Arabia.
Eur Arch Otorhinolaryngol. 2020 Jan;277(1):1-7. doi: 10.1007/s00405-019-05672-6. Epub 2019 Oct 29.
Although tonsillectomy is the most commonly performed surgical operation for children, its postoperative effect on the immune response was a source of debate among physicians.
The aim of this systemic review was study the effect of tonsillectomy on children immune response.
PubMed, Medline, Embase and Cochrane Library.
All relevant articles published English language addressing the effect of tonsillectomy on the immune system were included. One investigators extracted data regarding: year of the study, sample size, study design, sample size, timing of analysis, studied immune factors, result and conclusion were identified. Another investigator independently reviewed data accuracy.
Ten articles published between from January 2009 to January 2019 in about this issue that included 404 children were reviewed. All reviewed studies showed a non-significant difference between levels of indicators of the humeral immunity (IgA, IgG, IgM, C3 and C4) pre- and postoperatively. Studies that measured these indicators only after surgery, showed a non-significant difference in their levels between patients and healthy controls. Levels of indicators of cellular immunity (CD4+ , CD3+ , CD8+ , CD19+ , CD25+ , CD16+ , CD+ 56) showed slight reduction or increase in some studies but without a significant difference compared to their levels preoperatively, postoperatively at different intervals or with healthy controls. Other studies found no changes in these indicators postoperatively.
There was enough evidence to conclude that tonsillectomy has no negative affect on both humeral and cellular immunity of children.
尽管扁桃体切除术是儿童最常进行的手术操作，但它对免疫反应的术后影响一直是医生争论的焦点。
本系统评价的目的是研究扁桃体切除术对儿童免疫反应的影响。
PubMed、Medline、Embase 和 Cochrane Library。
纳入了所有以英语发表的、涉及扁桃体切除术对免疫系统影响的相关文章。一名调查员提取了以下数据：研究年份、样本量、研究设计、样本量、分析时间、研究的免疫因素、结果和结论。另一名调查员独立审查了数据的准确性。
共审查了 10 篇发表于 2009 年 1 月至 2019 年 1 月期间、涉及 404 名儿童的关于该问题的文章。所有综述研究均表明，术前和术后体液免疫指标（IgA、IgG、IgM、C3 和 C4）水平无显著差异。仅在术后测量这些指标的研究显示，患者与健康对照组之间的水平无显著差异。细胞免疫指标（CD4+、CD3+、CD8+、CD19+、CD25+、CD16+、CD+56）的水平在一些研究中略有下降或上升，但与术前、术后不同时间点或与健康对照组相比均无显著差异。其他研究发现术后这些指标没有变化。
有足够的证据表明扁桃体切除术对儿童的体液和细胞免疫均无负面影响。
