Hizli Omer, Kayabasi Serkan, Cengiz Bugra, Acar Aydin
Otolaryngology, Prof. Dr. A. Ilhan Ozdemir Education and Research Hospital, Giresun University, Giresun, TUR.
Otolaryngology, Faculty of Medicine, Aksaray University, Aksaray, TUR.
Cureus. 2020 Jun 19;12(6):e8701. doi: 10.7759/cureus.8701.
Introduction Tonsillectomy is one of the most common operations performed in the otolaryngology practice and there does not exist a systematic classification for tonsillectomy complications in the prior literature. In this study, we aimed at presenting a novel classification system to the current literature and analyzing complications of pediatric tonsillectomy based on this novel classification system. Methods A novel classification system based on modified Clavien classification was constituted for pediatric tonsillectomy complications. Medical records of 534 patients underwent tonsillectomy were retrospectively investigated and complication rates of tonsillectomy between children and adults were compared using this classification Results In total, 454 pediatric patients (258 males and 196 females, age range = 3-17 years) who underwent cold-knife tonsillectomy were eligible for the study. To compare the complication rates of the pediatric patients with adults, 80 adults with tonsillectomy (50 males and 30 females, age range 18-46) were also included. In children, the most common complication was dehydration, seen in 13 (2.86%) patients. The most serious complication was tooth aspiration (Grade 4a), seen in only one (0.22%) patient. Fifteen (3.3%) pediatric patients experienced more than one complication. Overall complication rate of pediatric tonsillectomy was 10.13% (46 patients). In adults, the most common complication was postoperative bleeding, seen in 11 (13.75%) adult patients. The most serious complication was Grade 3a postoperative bleeding, seen in four (5%) patients. Overall complication rate of adult tonsillectomy was 21.25% (17 patients). Overall complication rate of pediatric tonsillectomy was significantly lower compared with the complication rate of adult tonsillectomy (10.13% vs. 21.25%, p = 0.004, X= 8.07). Conclusion Modified Clavien classification is a novel and simple tool to analyze and categorize complications of pediatric tonsillectomy.
引言
扁桃体切除术是耳鼻喉科最常见的手术之一，既往文献中不存在扁桃体切除术并发症的系统分类。在本研究中，我们旨在向当前文献中呈现一种新颖的分类系统，并基于此新颖分类系统分析小儿扁桃体切除术的并发症。
方法
基于改良的Clavien分类法构建了小儿扁桃体切除术并发症的新颖分类系统。回顾性研究了534例行扁桃体切除术患者的病历，并使用该分类法比较儿童和成人扁桃体切除术的并发症发生率。
结果
共有454例接受冷刀扁桃体切除术的小儿患者（男258例，女196例，年龄范围3 - 17岁）符合研究条件。为比较小儿患者与成人的并发症发生率，还纳入了80例扁桃体切除术成人患者（男50例，女30例，年龄范围18 - 46岁）。在儿童中，最常见的并发症是脱水，13例（2.86%）患者出现。最严重的并发症是牙齿误吸（4a级），仅1例（0.22%）患者出现。15例（3.3%）小儿患者出现一种以上并发症。小儿扁桃体切除术的总体并发症发生率为10.13%（46例患者）。在成人中，最常见的并发症是术后出血，11例（13.75%）成人患者出现。最严重的并发症是3a级术后出血，4例（5%）患者出现。成人扁桃体切除术的总体并发症发生率为21.25%（17例患者）。小儿扁桃体切除术的总体并发症发生率显著低于成人扁桃体切除术的并发症发生率（10.13%对21.25%，p = 0.004，X = 8.07）。
结论
改良的Clavien分类法是一种新颖且简单的工具，用于分析和分类小儿扁桃体切除术的并发症。
