The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Clin Otolaryngol. 2022 May;47(3):471-477. doi: 10.1111/coa.13929. Epub 2022 Mar 22.
To identify paediatric intracapsular Coblation tonsillectomy procedures from routine administrative data in England, and determine their safety.
Retrospective observational cohort study of four ENT centres using routine data from Hospital Episode Statistics (HES).
Acute NHS trusts in England conducting exclusively intracapsular Coblation tonsillectomy.
Children (≤16 years old) undergoing bilateral intracapsular Coblation tonsillectomy.
Number of procedures, readmissions for pain, readmissions for bleeding and requirement for additional surgery for regrowth.
A total of 5525 procedures were identified. The median patient age was 4 (IQR 2-5). In-hospital complications occurred in 1%, with 0.1% returning to theatre for arrest of primary tonsil bleeding. Almost half of the procedures were conducted as a day-case (44%), with only a small proportion staying in hospital more than one night (7%). Within 28 days, 1.2% of patients were readmitted with bleeding, 0.7% with infection and 0.3% with pain; 0.2% of patients required return to theatre for control of secondary haemorrhage. Longitudinal follow-up has found that revision tonsil surgery is 0.3% at 1 year (n = 4498), 1.1% at 2 years (n = 2938), 1.7% at 3 years (n = 1781), 1.9% at 4 years (n = 905) and 2.2% at 5 years (n = 305).
Intracapsular coblation tonsillectomy safety outcomes in this study show primary and secondary bleeding rates and emergency return to theatre rates are lower than all tonsillectomy techniques reported in the National Prospective Tonsillectomy Audit and also lower than previously published Hospital Episode Statistics analysis of tonsillectomy procedures.
从英国常规行政数据中识别小儿扁桃体囊内低温射频消融切除术，并确定其安全性。
使用来自医院病例统计（HES）的常规数据，对四个耳鼻喉科中心进行回顾性观察性队列研究。
仅行扁桃体囊内低温射频消融切除术的英国急性 NHS 信托基金。
行双侧扁桃体囊内低温射频消融切除术的儿童（≤16 岁）。
手术数量、因疼痛而再次入院、因出血而再次入院以及因再生而需要再次手术的情况。
共确定了 5525 例手术。中位患者年龄为 4 岁（IQR 2-5 岁）。住院期间发生并发症的比例为 1%，其中 0.1%返回手术室以控制原发性扁桃体出血。近一半的手术（44%）为日间手术，只有一小部分（7%）住院超过一晚。在 28 天内，有 1.2%的患者因出血再次入院，0.7%的患者因感染再次入院，0.3%的患者因疼痛再次入院；0.2%的患者需要返回手术室以控制继发性出血。长期随访发现，1 年时（n=4498）需要再次行扁桃体切除术的比例为 0.3%，2 年时（n=2938）为 1.1%，3 年时（n=1781）为 1.7%，4 年时（n=905）为 1.9%，5 年时（n=305）为 2.2%。
本研究中扁桃体囊内低温射频消融切除术的安全性结果表明，原发性和继发性出血率以及紧急返回手术室率低于全国扁桃体切除术前瞻性审计报告的所有扁桃体切除术技术，也低于之前发表的基于医院病例统计分析的扁桃体切除术。
