The Catholic University of Korea, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Seoul, Republic of Korea.
The Catholic University of Korea, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Seoul, Republic of Korea.
Braz J Otorhinolaryngol. 2021 Sep-Oct;87(5):583-590. doi: 10.1016/j.bjorl.2019.12.007. Epub 2020 Jan 25.
Several surgical techniques have been used during tonsillectomy to reduce complications.
To assess the effects of pillar suture in conjunction with tonsillectomy as compared to tonsillectomy without suture in children.
Two authors independently searched five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) for studies published as recent as December 2018. Of the included studies, we compared tonsillectomy and pillar suture in combination (suture groups) with tonsillectomy alone,without suture, (control group). Postoperative pain intensity and other morbidities (e.g., postoperative bleeding, palatal hematoma, discomfort, and pillar edema) were measured during the postoperative period.
Postoperative bleeding [primary (OR = 0.47 [0.27; 0.81]) and secondary (OR = 0.14 [0.02; 0.78]) were significantly decreased in the pillar suture group compared to the control group. There were no significant differences between the two groups in postoperative pain at day 7 (SMD = -0.39 [-0.79; 0.00]), palatal hematoma (OR = 5.00 [0.22; 112.88]), palatal discomfort sensation (OR = 2.62 [0.60; 11.46]), site infection (OR = 5.27 [0.24; 113.35]), and velopharyngeal insufficiency (OR = 2.82 [0.11; 74.51]). By contrast, pillar edema (OR = 9.55 [4.29; 21.29]) was significantly increased in the pillar suture group compared to the control group.
Pillar suture combined with tonsillectomy may reduce postoperative bleeding incidence despite increasing pillar edema in pediatric tonsillectomy. Postoperative pain-relief, palatal hematoma, palatal discomfort sensation, site infection, and velopharyngeal insufficiency were not significantly altered compared to tonsillectomy alone. However, further studies are needed to corroborate the results of this study.
在扁桃体切除术中，已经使用了几种手术技术来减少并发症。
评估扁桃体切除术中使用柱缝线与单纯扁桃体切除术相比在儿童中的效果。
两位作者独立检索了五个数据库（PubMed、SCOPUS、Embase、Web of Science 和 Cochrane 数据库），以获取截至 2018 年 12 月发表的研究。在纳入的研究中，我们比较了扁桃体切除术和柱缝线联合（缝线组）与单纯扁桃体切除术（对照组）。在术后期间测量术后疼痛强度和其他并发症（如术后出血、腭血肿、不适和柱水肿）。
与对照组相比，柱缝线组术后出血（一级[OR=0.47[0.27;0.81]）和二级[OR=0.14[0.02;0.78]）明显减少。两组在第 7 天的术后疼痛（SMD=-0.39[-0.79;0.00]）、腭血肿（OR=5.00[0.22;112.88]）、腭部不适感（OR=2.62[0.60;11.46]）、部位感染（OR=5.27[0.24;113.35]）和软腭功能不全（OR=2.82[0.11;74.51]）方面无显著差异。相比之下，柱缝线组的柱水肿（OR=9.55[4.29;21.29]）明显增加。
尽管扁桃体切除术联合柱缝线会增加柱水肿，但可能会降低小儿扁桃体切除术后出血的发生率。与单纯扁桃体切除术相比，术后止痛、腭血肿、腭部不适感、部位感染和软腭功能不全无显著改变。然而，需要进一步的研究来证实本研究的结果。
