Austrian Tonsil Study Part 3: Surgical Technique and Postoperative Haemorrhage after Tonsillectomy

作者：Sarny S^*; Ossimitz G; Habermann W; Stammberger H

来源：Laryngo-Rhino-Otologie, 2013, 92(2): 92-96.

DOI：10.1055/s-0032-1330031

• tonsillectomy
• operation technique
• haemorrhage
• classification of bleeding episodes
• severity of bleeding episodes

Austrian Tonsil Study Part 3: Surgical Technique and Postoperative Haemorrhage after Tonsillectomy Background: Risk factors for postoperative haemorrhage after tonsillectomy are discussed controversy. In the past years surgical techniques were considered a determining factor for posttonsillectomy bleedings in several studies. %26lt;br%26gt;Material and Methods: In a prospective, multicentre study 9405 patients of whom 4437 underwent tonsillectomy and were focused in this article were evaluated during study period of 9 months (1st October 2009 till 30th June 2010). Postoperative haemorrhage was defined as any bleeding episode after extubation and classified according to a 7 grade scheme. %26lt;br%26gt;Results: Postoperative haemorrhage occurred in 14.4% (637/4437) patients with 4.6% (204/4437) requiring a return to theatre and 9.8% (433/4437) experiencing minor bleedings. Bipolar techniques (with or without cold steel dissection) showed a haemorrhage risk of 16.8% (62/370). Severe bleedings occurred significantly more often with the use of bipolar techniques (8% compared to 4.6% severe bleedings for all operation techniques, p=0.003). In addition, Coblation (R) technique had a higher postoperative haemorrhage rate (23.5%, 12/51). However, minor bleedings occurred in the majority of patients operated with Coblation technique (20% compared to 9.8% minor bleedings for all operation techniques, p%26lt;0.017). %26lt;br%26gt;Conclusion: Following the strict definition of postoperative haemorrhage, we found higher postoperative haemorrhage rates for bipolar techniques and Coblation technique. The proportion of severe bleedings is higher for bipolar methods, whereas the proportion of minor bleedings is higher for Coblation technique.

• 出版日期2013-2