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两种腺样体切除术技术的疗效和安全性比较研究:传统刮除腺样体切除术与内镜下微动力系统切除术的比较。

A comparative study of two adenoidectomy technics for efficacy and safety: Conventional curettage adenoidectomy versus endoscopic microdebrider adenoidectomy.

机构信息

Department of Otorhinolaryngology, Medient ENT Hospital, Istanbul, Turkey.

Department of Otorhinolaryngology, Ankara Atatürk Sanatoryum Training and Research Hospital, Gulhane Faculty of Medicine, Health Science University Turkey, Ankara, Turkey.

出版信息

Am J Otolaryngol. 2023 Jul-Aug;44(4):103807. doi: 10.1016/j.amjoto.2023.103807. Epub 2023 Mar 9.

Abstract

PURPOSE

Conventional cold curettage adenoidectomy (CCA) is the most used method for Adenoidectomy. With the advances in surgical instruments, endoscopy assisted less invasive techniques are coming into use. Herein we compared CCA with endoscopic microdebrider adenoidectomy (EMA) in terms of safety and recurrence.

METHODS

Patients who underwent adenoidectomy in our clinic between 2016 and 2021 years were included into the study. Study performed retrospectively. Patients operated with CCA accepted as GroupA and EMA as GroupB. Two groups compared for the recurrence rate and post-operative complications.

RESULTS

We studied 833 children aged between 3 and 12 years (mean 4,2 years old), had adenoidectomy, including 482 male(57.86 %) and 351 female (42.14 %). There were 473 patients in GroupA, and 360 patients in GroupB. Seventeen patients (%3.59) in GroupA had reoperation for the recurrence of adenoid tissue. There was no recurrence in GroupB. Residual tissue, recurrent hypertrophy, and postoperative otitis media rates were higher in GroupA, and this was statistically significant (p < 0.05). Whereas ventilation tube insertion rates didn't differ significantly (p > 0.05). Although hypernasality rate at second week was slightly higher in GroupB, this was not statistically significant (p > 0.05), and in further period it resolved in all patients. No major complications were reported.

CONCLUSION

Our study indicates that EMA is a safer technique than CCA, and prominent postoperative complications like residual adenoid tissue, recurrent adenoid hypertrophy, and postoperative otitis media with effusion rates are lower.

摘要

目的

传统的冷刮腺样体切除术(CCA)是腺样体切除术最常用的方法。随着手术器械的进步,内镜辅助的微创技术也在应用中。在此,我们比较了 CCA 和内镜微动力切除术(EMA)在安全性和复发方面的差异。

方法

我们将 2016 年至 2021 年间在我院行腺样体切除术的患者纳入研究。研究为回顾性研究。接受 CCA 手术的患者归入 A 组,接受 EMA 手术的患者归入 B 组。比较两组的复发率和术后并发症。

结果

我们研究了 833 名年龄在 3 至 12 岁之间(平均 4.2 岁)的儿童,他们接受了腺样体切除术,其中 482 名男性(57.86%)和 351 名女性(42.14%)。A 组 473 例,B 组 360 例。A 组有 17 例(3.59%)因腺样体组织复发而行再次手术。B 组无复发。A 组残留组织、复发肥大和术后中耳炎的发生率较高,差异有统计学意义(p<0.05)。而通气管插入率差异无统计学意义(p>0.05)。虽然 B 组术后第 2 周鼻音过高的发生率略高,但差异无统计学意义(p>0.05),且在随后的时间内所有患者均得到缓解。未报告严重并发症。

结论

我们的研究表明,EMA 是一种比 CCA 更安全的技术,术后并发症如残留腺样体组织、复发腺样体肥大和术后分泌性中耳炎的发生率较低。

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