Department of Otorhinolaryngology, İstanbul Medipol University Health Care Practice and Research Center Esenler Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2024 Jul;281(7):3735-3741. doi: 10.1007/s00405-024-08617-w. Epub 2024 Apr 6.
Adenoidectomy is one of the most commonly performed surgeries in pediatric otolaryngological practice. This prospective study compared three different adenoidectomy techniques' intra-operative and postoperative outcomes in pediatric patients. The techniques evaluated were classical (blind curettage), coblation, and a combined approach.
Ninety pediatric patients undergoing adenoidectomy were enrolled in the study. The patients were divided into three groups based on the technique used: Group A, classical adenoidectomy (blind curettage); Group B, coblation adenoidectomy and Group C, combined (blind curettage + coblation) adenoidectomy. The intra-operative time, degree of bleeding, and complications during and after the operations were recorded.
Group A had a significantly shorter operative time than the other groups. However, there was no significant difference in the mean operative time between Groups B and C. The mean amount of intra-operative bleeding differed significantly among the groups. Group B had significantly less bleeding than Group A or Group C. The amount of bleeding also differed significantly between Groups A and C. The postoperative pain scores did not differ significantly among the groups. While complications were infrequent in all groups, Group C did not exhibit a higher complication rate than Groups A and B. The absence of residual or recurrent adenoid tissue in any of the groups during long-term follow-up examinations highlights the effectiveness of all three adenoidectomy techniques in preventing adenoid regrowth.
The combined approach, which was one of the techniques studied, demonstrated an intermediate profile in terms of operative time and intra-operative bleeding compared to the classical and coblation techniques. These findings suggest that this combined approach may be a feasible option for adenoidectomy in pediatric patients, considering its similar low incidence of postoperative complications.
腺样体切除术是小儿耳鼻喉科最常进行的手术之一。本前瞻性研究比较了三种不同腺样体切除术技术在小儿患者中的术中及术后结果。评估的技术包括经典(盲刮)、等离子和联合方法。
90 名接受腺样体切除术的小儿患者纳入本研究。根据使用的技术将患者分为三组:A 组,经典腺样体切除术(盲刮);B 组,等离子腺样体切除术和 C 组,联合(盲刮+等离子)腺样体切除术。记录术中时间、出血程度以及手术期间和之后的并发症。
A 组的手术时间明显短于其他组。然而,B 组和 C 组之间的平均手术时间没有显著差异。术中出血量在各组之间存在显著差异。B 组的出血量明显少于 A 组或 C 组。A 组和 C 组之间的出血量也有显著差异。各组之间的术后疼痛评分无显著差异。虽然所有组的并发症都很少见,但 C 组的并发症发生率并不高于 A 组和 B 组。在长期随访检查中,所有组均未发现残留或复发性腺样体组织,这突出了所有三种腺样体切除术技术在预防腺样体再生方面的有效性。
在本研究中,联合方法与经典和等离子技术相比,在手术时间和术中出血方面表现出中等水平。这些发现表明,考虑到其术后并发症发生率较低,这种联合方法可能是小儿腺样体切除术的一种可行选择。