Department of Otorhinolaryngology, Linköping University Hospital, Linköping, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Acta Otolaryngol. 2020 Jul;140(7):589-596. doi: 10.1080/00016489.2020.1746396. Epub 2020 May 21.
To assure a high quality in tonsil surgery, it is necessary to monitor trends in clinical practice, complications and outcome. To describe rates and trends regarding indications, methods, techniques, complications, and outcome of tonsil surgery. 98 979 surgeries from the National Tonsil Surgery Register 2009-2018. Groups were categorised by indication and method. The proportion of patients undergoing tonsillotomy with adenoidectomy due to obstruction-snoring (mean age 5.3 y.) increased from 2009-2018. Hot tonsillectomy, but not tonsillotomy, techniques were related to a higher risk for postoperative bleeding. The use of cold techniques increased for all types of surgeries. The rates of patients reporting contact due to postoperative pain were associated with indication and method, with the lowest rate reported for tonsillotomy (4.5% in 2018) and the highest for tonsillectomy (34.5% in 2009). The rate of patients reporting that their symptoms were gone 6 months after surgery decreased. All hot tonsillectomy techniques should be avoided as they are related to a higher risk for postoperative bleeding. The high rate of postoperative contacts due to pain after tonsillectomy indicates a need for improvement in pain management. The declining rates of symptom relief must be investigated further.
为了确保扁桃体手术的高质量，有必要监测临床实践、并发症和结果的趋势。描述 2009 年至 2018 年国家扁桃体手术登记处的手术数量、适应症、方法、技术、并发症和结果的发生率和趋势。98979 例手术。按适应症和方法分类。由于阻塞性打鼾而行扁桃体腺样体切除术的扁桃体切除术患者比例（平均年龄 5.3 岁）从 2009 年至 2018 年增加。热扁桃体切除术，而不是扁桃体切除术，技术与术后出血风险增加有关。所有类型手术中冷技术的使用率都有所增加。报告因术后疼痛而联系的患者比例与适应症和方法有关，扁桃体切除术的最低报告率为 4.5%（2018 年），扁桃体切除术的最高报告率为 34.5%（2009 年）。报告术后 6 个月症状消失的患者比例下降。所有热扁桃体切除术技术均应避免，因为它们与术后出血风险增加有关。扁桃体切除术后因疼痛而导致的高比例术后接触表明需要改进疼痛管理。症状缓解率的下降必须进一步调查。
