Arens Philipp, Hardt Juliane, Angrick Julie Charlotte, Olze Heidi, Coordes Annekatrin
Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Front Pediatr. 2022 Dec 30;10:1049942. doi: 10.3389/fped.2022.1049942. eCollection 2022.
Surgical procedures in children are among the most commonly performed procedures in otolaryngology. Perioperative safety and documentation of complications are becoming increasingly important. This study investigates perioperative complications in a clinical cohort of children with adenotonsillar hyperplasia undergoing adenotonsillectomy using the standardized Dindo-Clavien reporting system.
Retrospective evaluation of 402 children who underwent adenotonsillectomy between 2009 and 2015. Patient parameters including all perioperative complications were investigated.
In the study, 124 complications were found (106 mild, 16 severe). According to the Dindo-Clavien classification, 93 grade I, 15 grade II, 5 grade III, 11 grade IV and 0 grade V complications were documented. Complications were associated with additional diagnoses ( = 0.001), long-term medication intake ( = 0.003), duration of hospitalization ( < 0.001) and duration of surgery ( < 0.001), undergoing tonsillotomy ( = 0.022) or tonsillectomy ( < 0.001), differences in ASA score ( = 0.005) and differences in OSA-18 score ( = 0.011). Severe complications, classified as grade III and IV, were associated with premature birth ( = 0.026), additional diagnoses ( = 0.017), long-term medication intake ( < 0.001) and differences in ASA score ( =< 0.001).
The Dindo-Clavien classification is a standardized reporting system which can also be used for surgical procedures in children with adenotonsillar hyperplasia. The system shows associations with clinical parameters and thus can help to identify subgroups at risk of severe complications.
儿童外科手术是耳鼻喉科最常见的手术之一。围手术期安全性及并发症记录变得愈发重要。本研究采用标准化的丁多-克莱维恩报告系统，调查行腺样体扁桃体切除术的腺样体扁桃体增生患儿临床队列中的围手术期并发症。
对2009年至2015年间接受腺样体扁桃体切除术的402例儿童进行回顾性评估。调查患者参数，包括所有围手术期并发症。
本研究共发现124例并发症（106例轻度，16例重度）。根据丁多-克莱维恩分类，记录到93例I级、15例II级、5例III级、11例IV级和0例V级并发症。并发症与附加诊断（P = 0.001）、长期药物摄入（P = 0.003）、住院时间（P < 0.001）和手术时间（P < 0.001）、接受扁桃体切开术（P = 0.022）或扁桃体切除术（P < 0.001）、美国麻醉医师协会（ASA）评分差异（P = 0.005）及儿童阻塞性睡眠呼吸暂停18项问卷（OSA - 18）评分差异（P = 0.011）相关。III级和IV级重度并发症与早产（P = 0.026）、附加诊断（P = 0.017）、长期药物摄入（P < 0.001）及ASA评分差异（P < 0.001）相关。
丁多-克莱维恩分类是一种标准化报告系统，也可用于腺样体扁桃体增生患儿的外科手术。该系统显示出与临床参数的相关性，因此有助于识别有重度并发症风险的亚组。
