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大型儿科病例系列中扁桃体切除术的短期结果

Short-Term Outcomes of Tonsillectomy in Large Paediatric Case Series.

作者信息

Attya Hisham Mohamed Anwar

机构信息

ENT Department, Faculty of Medicine, Cairo University, Cairo University Childrens Hospital, Al Inshaa WA Al Munirah, El Sayeda Zeinab, Cairo Governorate, Cairo, 4262010 Egypt.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5148-5153. doi: 10.1007/s12070-024-04916-0. Epub 2024 Aug 13.

DOI:10.1007/s12070-024-04916-0
PMID:39559063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11569066/
Abstract

Tonsillectomy is a commonly performed procedure in pediatric ENT departments worldwide. To comprehensively evaluate the morbidity associated with tonsillectomy techniques and potential factors that impact outcomes The present study examined the entirety of pediatric patients who underwent tonsillectomy or adenotonsillectomy at CUCH during the years 2021 and 2022. Comprehensive scrutiny was conducted on admissions and readmission data, which encompassed hospital episode statistics, operative notes, patient questionnaires, and electronic records. A total of 690 procedures were identified in our records, with 399 males and 291 females ranging in age from 1 to 13 years. The main indications for surgery included sleep-disordered breathing and recurrent tonsillitis. Among the patients, 233 underwent the surgery as a day case. Coblation intracapsular technique was used in 52% of cases, dissection method in 37%, and coblation extracapsular method in 10%. The incidence of post tonsillectomy bleeding (&infection) was 8.19%( 1.75%),14.89%(2.08%), 1.65%(1.65%) for dissection, coblation extracapsular and coblation intracapsular techniques respectively. Coblation intracapsular tonsillectomy has shown the lowest rate of postoperative hemorrhage compared to other techniques. Senior surgeons (consultants) had the lowest rate of post-tonsillectomy hemorrhage; however, this difference did not reach statistical significance.

摘要

扁桃体切除术是全球儿科耳鼻喉科常见的手术。为了全面评估与扁桃体切除技术相关的发病率以及影响手术结果的潜在因素,本研究对2021年和2022年在CUCH接受扁桃体切除术或腺样体扁桃体切除术的所有儿科患者进行了检查。对入院和再入院数据进行了全面审查,包括医院事件统计、手术记录、患者问卷和电子记录。我们的记录中总共确定了690例手术,其中男性399例,女性291例,年龄在1至13岁之间。手术的主要适应症包括睡眠呼吸障碍和复发性扁桃体炎。其中,233例患者作为日间手术接受了手术。52%的病例采用了低温等离子刀囊内技术,37%采用了剥离法,10%采用了低温等离子刀囊外技术。扁桃体切除术后出血(和感染)的发生率,剥离法、低温等离子刀囊外法和低温等离子刀囊内法分别为8.19%(1.75%)、14.89%(2.08%)、1.65%(1.65%)。与其他技术相比,低温等离子刀囊内扁桃体切除术的术后出血率最低。资深外科医生(顾问)的扁桃体切除术后出血率最低;然而,这种差异没有达到统计学意义。

相似文献

1
Short-Term Outcomes of Tonsillectomy in Large Paediatric Case Series.大型儿科病例系列中扁桃体切除术的短期结果
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2
Coblation versus other surgical techniques for tonsillectomy.用于扁桃体切除术的低温等离子消融术与其他手术技术的比较
Cochrane Database Syst Rev. 2017 Aug 22;8(8):CD004619. doi: 10.1002/14651858.CD004619.pub3.
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本文引用的文献

1
Intracapsular Tonsillectomy Using Plasma Ablation Versus Total Tonsillectomy: A Systematic Literature Review and Meta-Analysis.使用等离子消融术的囊内扁桃体切除术与全扁桃体切除术的系统文献综述和荟萃分析
OTO Open. 2023 Feb 17;7(1):e22. doi: 10.1002/oto2.22. eCollection 2023 Jan-Mar.
2
Intrapatient Comparison of Coblation versus Electrocautery Tonsillectomy in Children: A Randomized, Controlled Trial.儿童低温等离子射频消融术与电灼扁桃体切除术的患者内比较:一项随机对照试验
J Clin Med. 2022 Aug 4;11(15):4561. doi: 10.3390/jcm11154561.
3
Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials.低温等离子扁桃体切除术与激光扁桃体切除术的比较:随机对照试验的系统评价和荟萃分析。
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5511-5520. doi: 10.1007/s00405-022-07534-0. Epub 2022 Jul 9.
4
Comparative systematic review and meta-analysis of the therapeutic effects of coblation tonsillectomy versus electrocautery tonsillectomy.低温等离子体扁桃体切除术与电灼扁桃体切除术治疗效果的比较系统评价与荟萃分析。
Gland Surg. 2022 Jan;11(1):175-185. doi: 10.21037/gs-21-832.
5
Intracapsular tonsillectomy versus extracapsular tonsillectomy: a safety comparison.扁桃体囊内切除术与扁桃体囊外切除术:安全性比较。
J Laryngol Otol. 2022 Aug;136(8):720-725. doi: 10.1017/S0022215121002565. Epub 2021 Sep 29.
6
Coblation intracapsular tonsillectomy in children: A prospective study of 1257 consecutive cases with long-term follow-up.儿童等离子扁桃体切除术:1257 例连续病例的前瞻性研究及长期随访。
Clin Otolaryngol. 2021 Nov;46(6):1184-1192. doi: 10.1111/coa.13790. Epub 2021 Jul 29.
7
Application of Coblation Tonsillectomy with Inferior Pole Capsule Preservation in Pediatric Patients.低温等离子扁桃体切除术联合下极被膜保留技术在小儿患者中的应用。
Laryngoscope. 2021 May;131(5):1157-1162. doi: 10.1002/lary.29089. Epub 2020 Sep 25.
8
Intracapsular coblation tonsillectomy versus extracapsular coblation tonsillectomy: a systematic review and a meta-analysis.经黏膜下切除术与经黏膜外切除术治疗扁桃体的比较:系统评价和荟萃分析。
Eur Arch Otorhinolaryngol. 2021 Mar;278(3):637-644. doi: 10.1007/s00405-020-06178-2. Epub 2020 Jul 4.
9
Tonsillectomy or tonsillotomy? A systematic review for paediatric sleep-disordered breathing.扁桃体切除术还是扁桃体切开术?小儿睡眠呼吸障碍的系统评价
Int J Pediatr Otorhinolaryngol. 2017 Dec;103:41-50. doi: 10.1016/j.ijporl.2017.10.008. Epub 2017 Oct 5.
10
Coblation versus other surgical techniques for tonsillectomy.用于扁桃体切除术的低温等离子消融术与其他手术技术的比较
Cochrane Database Syst Rev. 2017 Aug 22;8(8):CD004619. doi: 10.1002/14651858.CD004619.pub3.