Losgar Hannah, Boeger Daniel, Buentzel Jens, Hoffmann Kerstin, Podzimek Jiri, Kaftan Holger, Mueller Andreas, Tresselt Sylvia, Geißler Katharina, Guntinas-Lichius Orlando
Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
Department of Otorhinolaryngology, Zentralklinikum, Suhl, Germany.
Sci Rep. 2025 Jul 31;15(1):27967. doi: 10.1038/s41598-025-13803-9.
Population-based data on incidence of complications after pediatric adenoidectomy are sparse. Therefore, a retrospective population-based study of all 2105 pediatric adenoidectomies (59.9% male, median age: 4 years) in the year 2019 in all otolaryngology departments in one federal state, Thuringia, in Germany, was performed. Patients' and treatment characteristics, and complications were analyzed. The highest surgery rate was seen at the age of 3 years (2747.4 per 100,000 children). Adenoidectomy was combined with tonsillotomy or tonsillectomy in 29.2% and 1.5% of the cases. Postoperative bleeding needing re-surgery occurred in 1.1% of all cases. The revision surgery for bleeding rate after solitary adenoidectomy was 0.7%. A wound infection was seen in 1.0%. Complications classified according to the Clavien-Dindo classification (CDC) occurred in 2.6% of cases. The overall complication rate was 20.3/100,000 population. Additional tonsillectomy was independently associated to bleeding > 24 h after surgery (Odds ratio [OR] = 52.141; confidence interval [CI] = 7.772-349.818; p < 0.0001). There was no independent associative factor to enhanced risk of wound infection. CDC complications occurred more frequently in comorbid patients (OR = 4.175; CI = 1.222-14.271; p = 0.023), underweight children (OR = 2.430; CI = 1.198-6.571; p = 0.040), when additional tonsillectomy was performed (OR = 11.177; CI = 2.098-59.548; p < 0.0001), and when perioperative antibiotics were applied (OR = 13.251; CI = 5.695-30.834; p < 0.001). Adenoidectomy is very safe surgery. Main risk factor for bleeding complications is additional tonsillectomy, not adenoidectomy itself.
关于小儿腺样体切除术后并发症发生率的基于人群的数据较为稀少。因此，对德国图林根州所有耳鼻喉科在2019年进行的2105例小儿腺样体切除术（男性占59.9%，中位年龄：4岁）进行了一项基于人群的回顾性研究。分析了患者及治疗特征和并发症情况。手术率最高出现在3岁时（每10万名儿童中有2747.4例）。在29.2%和1.5%的病例中，腺样体切除术分别与扁桃体切开术或扁桃体切除术联合进行。所有病例中有1.1%发生了需要再次手术的术后出血。单纯腺样体切除术后出血的再次手术率为0.7%。出现伤口感染的比例为1.0%。根据Clavien-Dindo分类（CDC）分类的并发症发生在2.6%的病例中。总体并发症发生率为每10万人中20.3例。额外的扁桃体切除术与术后出血超过24小时独立相关（比值比[OR]=52.141；置信区间[CI]=7.772 - 349.818；p<0.0001）。没有增加伤口感染风险的独立相关因素。CDC并发症在合并症患者中更频繁发生（OR=4.175；CI=1.222 - 14.271；p=0.023）、体重过轻的儿童中（OR=2.430；CI=1.198 - 6.571；p=0.040）、进行额外扁桃体切除术时（OR=11.177；CI=2.098 - 59.548；p<0.0001）以及应用围手术期抗生素时（OR=13.251；CI=5.695 - 30.834；p<0.001）。腺样体切除术是非常安全的手术。出血并发症的主要危险因素是额外的扁桃体切除术，而非腺样体切除术本身。
