ERİŞKİN HASTALARDA TONSİLLEKTOMİ SONRASI GÖRÜLEN KANAMALARIN RETROSPEKTİF ANALİZİ

Year 2022, , 312 - 316, 18.07.2022

İsmail Çevik , Fatih Yücedağ , Ergün Sevil

https://doi.org/10.18229/kocatepetip.957390

Abstract

AMAÇ: Bu çalışmada tonsillektomi sonrası kanayan hastaların özelliklerini belirlemek ve bu hastalara yaklaşımlarımızı araştırmak amaçlanmıştır.
GEREÇ VE YÖNTEM: Bu çalışmamızda tonsillektomi sonrası kanama ile kliniğimize başvuran 29 hastanın kayıtları geriye dönük incelendi. Hastaların yaş, cinsiyet, ameliyattan sonra kaçıncı gün kanadığı, laboratuvar parametreleri, kanama sebepleri, uygulanan cerrahi teknik ve kanama müdahale yöntemleri araştırıldı.
BULGULAR: Hastaların 11 (%37,9)’i kadın, 18 (%62,06)’i erkek olup yaş ortalaması 26,8 (18-45) yıl idi. 25 hastaya soğuk bıçak yöntemi ile, 4 hastaya ise bipolar koter yardımı ile tonsillektomi yapıldı. Ameliyattan sonra kanama nedeni ile ortalama başvuru süresi 7,3 (1-19) gün idi. Altı (%20,6) hastada kanama nedeni tespit edilebildi. İki hastaya konservatif tedavi yöntemleri uygulandı, hastaların 14’üne (%48,2) lokal, 13’üne (%44,8) ise genel anestezi altında kanama müdahalesi yapıldı.
SONUÇ: Tonsillektomi sonrası kanamalara erişkin hastalarda sık rastlanmakta ve bu durum hayatı tehdit edici sonuçlar doğurmaktadır. Yeni tedavi yöntemleri ve kanama sonrası erken müdahale ile olası komplikasyonların önüne geçilebilir.

Keywords

Tonsillektomi, Kanama, Komplikasyonlar, Risk faktörleri.

Supporting Institution

HERHANGİ BİR KURUMDAN FİNANS DESTEĞİ ALINMAMAKTA.

RETROSPECTIVE ANALYSIS OF POSTOPERATIVE TONSILLECTOMY BLEEDING IN ADULT PATIENTS

Abstract

OBJECTIVE: In this study, it is aimed to determine the features of patients who bleed after tonsillectomy and to investigate our approaches to these patients.
MATERIAL AND METHODS: The records of 29 patients admitted to our clinic with post-tonsillectomy hemorrhage were retrospectively evaluated. The patients' age, gender, the bleeding day after the operation, laboratory parameters, causes of bleeding, surgical technique and approaching methods for bleeding were investigated.
RESULTS: 11 (37.9%) of the patients were female and 18 (62.06%) were male, with a mean age of 26.8 (18-45) years. Tonsillectomy was performed with the cold knife method in 25 patients and with the help of bipolar cautery in 4 patients. The mean time for admission due to bleeding after surgery was 7.3 (1-19) days. The cause of bleeding could be detected in six (20.6%) patients. Conservative treatment methods were applied to two patients, hemorrhage intervention was performed under local anesthesia in 14 (48.2%) and general anesthesia in 13 patients (44.8%).
CONCLUSIONS: Bleeding after tonsillectomy is frequently seen in adult patients and this situation results in life-threatening consequences. Possible complications can be prevented with new treatment methods and early intervention after bleeding.

Keywords

Tonsillectomy, Bleeding, Complications, Risk factors.

References

• 1. Østvo E, Sunnergren O, Ericsson E, et al. Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden. Eur Arch Otorhinolaryngol. 2015;272(3): 737-43.
• 2. Leong SC, Karkos PD, Papouliakos SM, Apostolidou MT, Unusual complications of tonsillectomy: a systematic review. Am J Otolaryngol. 2007; 28: 419-22.
• 3. Krishna P, Lee D. Post-tonsillectomy bleeding: A meta analysis. Laryngoscope. 2001;111(8):1358-61.
• 4. Collison PJ, Mettler B. Factors associated with post-tonsillectomy hemorrhage. Ear Nose Throat J. 2000;79(8):640-2.
• 5. Arora R, Saraiya S, Niu X, Thomas RL, Kannikeswaran N. Post tonsillectomy hemorrhage: who needs intervention? Int J Pediatr Otorhinolaryngol. 2015;79(2):165-9.
• 6. Sarny S, Ossimitz G, Habermann W, Stammberger H. Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope. 2011;121(12):2553-60.
• 7. Bajaj Y, Atkinson H, Sagoo R, Bhatti I, Newbegin C. Paediatric day-case tonsillectomy: a three-year prospective audit spiral in a district hospital. J Laryngol Otol. 2012;126:159- 62.
• 8. Tuchtan L, Torrents J, Lebreton-Chakour C, et al. Liability under post-tonsillectomy lethal bleeding of the tonsillar artery: a report of two cases. Int J Pediatr Otorhinolaryngol. 2015;79:83-7.
• 9. Goldman JL, Baugh RF, Davies L, et al. Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope. 2013;123(10):2544-53.
• 10. Ali RB, Smyth D, Kane R, Donnelly M. Post-tonsillectomy bleeding: a regional hospital experience. Ir J Med Sci. 2008; 177(8):297-301.
• 11. Lee MS, Montague ML, Hussain SS. Posttonsillectomy hemorrhage: cold versus hot dissection. Otolaryngol Head Neck Surg. 2004;131(6):833-6.
• 12. Lowe D, van der Meulen J, Cromwell D, et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope. 2007;117(4): 717-24.
• 13. Cakır A, Boran C, Olgun Y, Erdag T. Posttonsillectomy bleeding: our 10-year experience. The Turkish Journal of Ear Nose and Throat. 2017;27 (1):1-9.
• 14. Randa DA, Hoffer ME. Complications of tonsillectomy and adenoidectomy Otolaryngol Head Neck Surg. 1998;118(1): 61-8.
• 15. Roberts C, Jayaramachandran S, Raine CH. A prospective study of factors which may predispose to post-operattive tonsillar fossae haemorrhage. Clin Otolaryngol. 1992;17:13-7.
• 16. Wei JL, Beatty CW, Gustafon RO. Evaluation of posttonsi ectomy hemorrhage and risk factors. Otolaryngol Head Neck Surg. 2000;123 (3):229-35.
• 17. Ozkırış M. Comparison of three techniques in pediatric tonsillectomy. Eur Arch Otorhino Laryngol. 2012;269(5):1497-501.