Year 2018, Volume 20 , Issue 1, Pages 7 - 10 2018-08-03

Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?
Cerrahi Teknik Post Tonsillektomi Hemoraji Oranını Anlamlı Olarak Değiştirir mi?

Yusuf DÜNDAR [1] , Hümeyra BAYRAM AKCAN [2] , Derya CEBECİ [3] , Ahmet ULUAT [4] , Fatih Alper AKCAN [5]


Aim: Tonsillectomy is one of the most common surgical procedures in the pediatric population, as well as one of the first operations learned during otolaryngology residency. This study aims to evaluate the effect of surgical technique on the occurrence of post-tonsillectomy hemorrhage.

Material and Methods: This prospectively-designed clinical trial was conducted in a tertiary referral center between May 2012 and April 2015. A total of 608 patients had tonsillectomies performed by a single surgeon with three different surgical techniques used during the study period. Patients in group one were operated on using cold dissection; group two comprised patients who underwent bipolar cautery; group three had the posterior pillar mucosal suturing technique performed.

Results: 608 patients met inclusion criteria; 165 of them in group one, 274 in group two, and 169 in group three. The median age was 5 (2-14) years old. A total of five patients (0.82%) experienced post-operative bleeding. One of these patients (from group one) experienced primary hemorrhage. The four others were considered secondary hemorrhage; two from each the bipolar cautery and posterior pillar mucosal suturing groups. The rates of post-operative hemorrhage in each group were 0.61%, 0.73% and 1.18%, respectively (p=0.861). Only one of the five patients necessitated a return to the operating room to control the bleeding.

Conclusion: Our study findings suggest that the choice of surgical technique does not affect the post-tonsillectomy bleeding rate. There were no significant differences in bleeding rates between subgroups.

Amaç: Tonsillektomi pediatrik populasyonda en sık uygulanan cerrahi girişimlerden biridir ve KBB eğitiminde ilk öğrenilen işlemlerdendir. Bu çalışma, tonsillektomi sonrası kanamada cerrahi tekniğin etkili olup olmadığını değerlendirmeyi amaçlamıştır.

Gereç ve Yöntemler: Bu prospektif planlı klinik çalışma, Mayıs 2012 ile Nisan 2015 arasında bir üçüncü basamak sağlık merkezinde gerçekleştirildi. Çalışma süresince, aynı cerrah tarafından 3 farklı teknikle toplam 608 hasta ameliyat edildi. Grup 1'de soğuk diseksiyon ile ameliyat edilen çocuklar, Grup 2'de bipolar koter ile opere edilen çocuklar, Grup 3’de ise posterior pillar mukozal sütür tekniği ile opere edilen çocuklar yer aldı.

Bulgular: Soğuk diseksiyon (n=165), bipolar koter (n=274) ve posterior pillar mukozal sütür (n=169) tekniklerine toplam 608 hasta dahil edildi. Yaş ortancası 5 (2-14) idi. Beş hastada (%0,82) ameliyat sonrası kanama oldu. Bu hastalardan sadece birinde primer hemoraji gözlenmiş olup, hasta soğuk diseksiyon grubunda yer almaktaydı. Beş hastanın dördünde sekonder kanama gözlendi ve bu hastalar bipolar koter grubu ve posterior pillar mukozal sütür gruplarındaydı. Postoperatif hemoraji oranları gruplar için sırasıyla %0.61, %0,73 ve %1,18 olarak tespit edildi (p=0,861). Kanamayı kontrol etmek için ameliyat odasına sadece beş hastadan biri transfer edildi.

Sonuç: Çalışmamızın bulguları, cerrahi tekniğin tonsillektomi sonrası kanama oranını etkilemediğini desteklemektedir. Farklı cerrahi teknikler arasında primer ve sekonder kanamada oranları açısından anlamlı fark olmadığı görüldü.

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Primary Language en
Subjects Health Care Sciences and Services
Journal Section Research Article
Authors

Author: Yusuf DÜNDAR
Institution: Wayne State University Department Of Otolaryngology –Head &Neck Surgery, Detroit/MI, USA
Country: United States


Author: Hümeyra BAYRAM AKCAN
Institution: Ministry of Health , Atatürk Hospital, Department of Internal Medicine, Düzce, Turkey
Country: Turkey


Author: Derya CEBECİ
Institution: Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey
Country: Turkey


Author: Ahmet ULUAT
Institution: Ministry of Health , Evliya Çelebi Training and Research Hospital, Department of Otolaryngology, Kutahya, Turkey
Country: Turkey


Author: Fatih Alper AKCAN (Primary Author)
Institution: Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey
Country: Turkey


Dates

Publication Date : August 3, 2018

Bibtex @research article { dtfd444200, journal = {Duzce Medical Journal}, issn = {}, eissn = {1307-671X}, address = {}, publisher = {Duzce University}, year = {2018}, volume = {20}, pages = {7 - 10}, doi = {10.18678/dtfd.444200}, title = {Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?}, key = {cite}, author = {Dündar, Yusuf and Bayram Akcan, Hümeyra and Cebeci, Derya and Uluat, Ahmet and Akcan, Fatih Alper} }
APA Dündar, Y , Bayram Akcan, H , Cebeci, D , Uluat, A , Akcan, F . (2018). Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage? . Duzce Medical Journal , 20 (1) , 7-10 . DOI: 10.18678/dtfd.444200
MLA Dündar, Y , Bayram Akcan, H , Cebeci, D , Uluat, A , Akcan, F . "Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?" . Duzce Medical Journal 20 (2018 ): 7-10 <https://dergipark.org.tr/en/pub/dtfd/issue/38727/444200>
Chicago Dündar, Y , Bayram Akcan, H , Cebeci, D , Uluat, A , Akcan, F . "Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?". Duzce Medical Journal 20 (2018 ): 7-10
RIS TY - JOUR T1 - Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage? AU - Yusuf Dündar , Hümeyra Bayram Akcan , Derya Cebeci , Ahmet Uluat , Fatih Alper Akcan Y1 - 2018 PY - 2018 N1 - doi: 10.18678/dtfd.444200 DO - 10.18678/dtfd.444200 T2 - Duzce Medical Journal JF - Journal JO - JOR SP - 7 EP - 10 VL - 20 IS - 1 SN - -1307-671X M3 - doi: 10.18678/dtfd.444200 UR - https://doi.org/10.18678/dtfd.444200 Y2 - 2018 ER -
EndNote %0 Düzce Tıp Fakültesi Dergisi Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage? %A Yusuf Dündar , Hümeyra Bayram Akcan , Derya Cebeci , Ahmet Uluat , Fatih Alper Akcan %T Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage? %D 2018 %J Duzce Medical Journal %P -1307-671X %V 20 %N 1 %R doi: 10.18678/dtfd.444200 %U 10.18678/dtfd.444200
ISNAD Dündar, Yusuf , Bayram Akcan, Hümeyra , Cebeci, Derya , Uluat, Ahmet , Akcan, Fatih Alper . "Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?". Duzce Medical Journal 20 / 1 (August 2018): 7-10 . https://doi.org/10.18678/dtfd.444200
AMA Dündar Y , Bayram Akcan H , Cebeci D , Uluat A , Akcan F . Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?. Duzce Medical Journal. 2018; 20(1): 7-10.
Vancouver Dündar Y , Bayram Akcan H , Cebeci D , Uluat A , Akcan F . Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?. Duzce Medical Journal. 2018; 20(1): 7-10.
IEEE Y. Dündar , H. Bayram Akcan , D. Cebeci , A. Uluat and F. Akcan , "Does Surgical Technique Significantly Change the Rate of Post-Tonsillectomy Hemorrhage?", Duzce Medical Journal, vol. 20, no. 1, pp. 7-10, Aug. 2018, doi:10.18678/dtfd.444200