Biradar Kashiroygoud, Kumar Sanjay, Patra A K
Department of ENT-HNS, Command Hospital Airforce, Bangalore, India.
Department of Anaesthesiology, Command Hospital Airforce, Bangalore, India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):191-199. doi: 10.1007/s12070-023-04125-1. Epub 2023 Aug 26.
Traditional Cold Steel Adenoidectomy (TCSA) and Endoscopic-Assisted Cold Steel Adenoidectomy (EACSA) frequently employ surgical adenoid removal methods. While these techniques effectively treat adenoid- related conditions, their influence on patients' psychological well-being still needs to be more adequately explored. With the increasing focus on the significance of mental well-being in surgical results, this study sought to explore and differentiate the psychological impacts of TCSA and EACSA. The primary objective was to examine and compare anxiety levels between TCSA and EACSA groups. Secondary objectives included evaluating surgical apprehension, post- surgery psychological well-being, procedural satisfaction, postoperative pain, duration until return to daily activities, and occurrence of postoperative complications. In a prospective, randomized controlled trial, 100 patients undergoing adenoidectomy were randomly allocated to the TCSA or EACSA group. The Hospital Anxiety and Depression Scale (HADS) was employed to evaluate anxiety levels at one week, one month, and three months following the surgery. Additional outcomes included surgical apprehension, post-surgery psychological well-being, procedural satisfaction, postoperative pain, time until return to daily activities, and postoperative complications. The EACSA group exhibited significantly lower HADS scores, surgical apprehension scores, and postoperative pain, alongside higher post-surgery psychological well-being scores and procedural satisfaction compared to the TCSA group ( < 0.05). Moreover, the EACSA group had a significantly shorter duration until the return to daily activities ( < 0.05). There were no significant variations found between the groups in terms of either the amount of bleeding during the procedure or the length of the operation. However, the EACSA group demonstrated a lower occurrence of postoperative complications, such as bleeding and infection. The results indicate that EACSA may provide benefits over TCSA in terms of reduced anxiety levels, surgical apprehension, postoperative pain, time until return to daily activities, and enhanced post-surgery psychological well-being and patient satisfaction. These findings could support clinicians in making informed decisions and offering patient counselling when choosing the most appropriate surgical technique based on patients' psychological health. Nevertheless, additional research is required to assess the enduring psychological consequences of these methods.
传统冷钢腺样体切除术（TCSA）和内镜辅助冷钢腺样体切除术（EACSA）是常用的手术腺样体切除方法。虽然这些技术能有效治疗腺样体相关疾病，但其对患者心理健康的影响仍有待更充分地探究。随着人们越来越关注心理健康在手术结果中的重要性，本研究旨在探索并区分TCSA和EACSA的心理影响。主要目的是检查和比较TCSA组和EACSA组的焦虑水平。次要目的包括评估手术恐惧、术后心理健康、手术过程满意度、术后疼痛、恢复日常活动所需时间以及术后并发症的发生情况。在一项前瞻性随机对照试验中，100例行腺样体切除术的患者被随机分配至TCSA组或EACSA组。采用医院焦虑抑郁量表（HADS）评估术后1周、1个月和3个月时的焦虑水平。其他结果包括手术恐惧、术后心理健康、手术过程满意度、术后疼痛、恢复日常活动的时间以及术后并发症。与TCSA组相比，EACSA组的HADS评分、手术恐惧评分和术后疼痛显著更低，术后心理健康评分和手术过程满意度更高（<0.05）。此外，EACSA组恢复日常活动的时间显著更短（<0.05）。两组在手术过程中的出血量或手术时长方面均未发现显著差异。然而，EACSA组术后并发症（如出血和感染）的发生率较低。结果表明，EACSA在降低焦虑水平、手术恐惧、术后疼痛、恢复日常活动的时间以及提高术后心理健康和患者满意度方面可能比TCSA更具优势。这些发现可为临床医生在根据患者心理健康选择最合适的手术技术时提供参考，帮助他们做出明智的决策并为患者提供咨询。不过，还需要进一步研究来评估这些方法的长期心理影响。
