Alsharif Shouq, Alessa Sarah, Alshiqayhi Salwa, AlAmoudi Ebtihaj, Alobiri Futoon, Amro Sara, Alem Hisham
Medicine, Kind Abdulaziz University Hospital, Jeddah, SAU.
Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2020 May 3;12(5):e7945. doi: 10.7759/cureus.7945.
Background Adenoidectomy is the most commonly performed pediatric operation worldwide and one of the most frequent otorhinolaryngological procedures. It is a safe procedure with a low risk of complications. However, after a successful adenoidectomy, few patients experience symptoms of nasal obstruction, suggestive of adenoid regrowth. Because of various risk factors, patients require a revision adenoidectomy. This study aimed to determine the incidence of revision adenoidectomy at King Abdulaziz University Hospital (KAUH). Moreover, we aimed to identify the characteristics and factors that present a risk of revision adenoidectomy in pediatric patients. Materials and Methods We retrospectively reviewed the medical records of 680 pediatric patients (age below 18 years) of Saudi and non-Saudi descent who underwent a prior adenoidectomy with or without tonsillectomy, as well as those who underwent a revision adenoidectomy. The data from 2015 to 2018 were obtained from the hospital medical records using a data collection sheet. The data were entered on to a Microsoft excel sheet, and descriptive statistical analysis was performed using IBM SPSS software V21 (IBM Corp., Armonk, NY). Results The incidence of revision adenoidectomy at our center was 2.79%. We found significant relationships between comorbidities and revision adenoidectomy (p=0.014), initial adenoidectomy without tonsillectomy and revision adenoidectomy (p=0.001), and a young age at initial surgery and revision adenoidectomy. The mean age at initial adenoidectomy was 2.5 years (standard deviation [SD], ±0.607 years), whereas that at revision adenoidectomy was 1.89 years (SD, ±0.737 years). The mean interval between primary and revision adenoidectomies was 42.32 months (range, 9-86 months). Conclusion The incidence of revision adenoidectomy at KAUH was 2.79%. Moreover, only adenoidectomy without a tonsillectomy presented a high risk of adenoid regrowth necessitating a revision adenoidectomy. Therefore, we recommend counseling patients to undergo an adenoidectomy with tonsillectomy to reduce the risk of revision adenoidectomy.
腺样体切除术是全球最常开展的小儿外科手术之一,也是耳鼻咽喉科最常见的手术之一。这是一种安全的手术,并发症风险较低。然而,在成功进行腺样体切除术后,少数患者会出现鼻塞症状,提示腺样体再生。由于存在各种风险因素,患者需要进行腺样体切除修正手术。本研究旨在确定阿卜杜勒阿齐兹国王大学医院(KAUH)腺样体切除修正手术的发生率。此外,我们旨在确定小儿患者中存在腺样体切除修正手术风险的特征和因素。
我们回顾性分析了680例沙特和非沙特裔小儿患者(年龄在18岁以下)的病历,这些患者之前接受过腺样体切除术,可伴有或不伴有扁桃体切除术,以及接受过腺样体切除修正手术的患者。2015年至2018年的数据通过数据收集表从医院病历中获取。数据录入Microsoft Excel工作表,并使用IBM SPSS软件V21(IBM公司,纽约州阿蒙克)进行描述性统计分析。
我们中心腺样体切除修正手术的发生率为2.79%。我们发现合并症与腺样体切除修正手术之间存在显著相关性(p=0.014),初次腺样体切除术未行扁桃体切除术与腺样体切除修正手术之间存在显著相关性(p=0.001),以及初次手术时年龄较小与腺样体切除修正手术之间存在显著相关性。初次腺样体切除术的平均年龄为2.5岁(标准差[SD],±0.607岁),而腺样体切除修正手术时的平均年龄为1.89岁(SD,±0.737岁)。初次与修正腺样体切除术之间的平均间隔时间为42.32个月(范围,9 - 86个月)。
KAUH腺样体切除修正手术的发生率为2.79%。此外,只有未行扁桃体切除术的腺样体切除术存在腺样体再生的高风险,需要进行腺样体切除修正手术。因此,我们建议告知患者接受腺样体切除术时同时行扁桃体切除术,以降低腺样体切除修正手术的风险。