Post-tonsillectomy bleeding: The effect of surgical experience

Year 2023, , 199 - 203, 31.08.2023

Talih Özdaş , Nuray Bayar Muluk , Vedat Delibaş , Mustafa Çağrı Derici , Sanem Okşan Erkan , Birgül Tuhanioğlu , Orhan Görgülü , Osman Kürşat Arıkan

https://doi.org/10.36516/jocass.1240290

Abstract

Aim: We aimed to discuss and investigate the relationship between the surgeon's experience and post-tonsillectomy bleeding (PTB) in the light of the literature.

Methods: The retrospective data was obtained from 280 patients who underwent tonsillectomy (32 PTB and 248 no-PTB) operated by residents or consultant surgeons.

Results: The overall bleeding rate after tonsillectomy was 11.43% (32/280). The bleeding rate was 14.3% in the <16 age group and 9.7% in the ≥16 age group (p=0.246). While the rate of bleeding after tonsillectomy operation was 6.16% in the resident group; it was 27.53% in the consultant group (p<0.001). In patients who bled after tonsillectomy operation, the operation time was significantly shorter in the consultant group (p=0.032). Binary Logistic Regression analysis revealed that being a consultant surgeon is a risk factor for bleeding after tonsillectomy operation (p<0.001). Short operation time was a weak risk factor (p=0.048).

Conclusions: More experience in surgery does not decrease the risk for PTB, quite the reverse, it increases the PTB risk. The effort to finish surgery in a short time, and possibility of performing a less careful and more traumatic surgery might have caused this result.

Keywords

Tonsillectomy, post-tonsillectomy bleeding, resident, consultant, surgeon’s experience

Supporting Institution

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Project Number

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Thanks

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Tonsillektomi sonrası kanama: Cerrahi deneyimin etkisi

Abstract

Amaç: Çalışmamızda cerrahın deneyimi ile tonsillektomi operasyonu sonrası kanama (TOSK) arasındaki ilişkiyi literatür eşliğinde tartışmayı ve araştırmayı amaçladık.

Materyal ve Metot: Retrospektif veriler, asistan veya uzman cerrahlar tarafından tonsillektomi operasyonu uygulanan (32 TOSK olan ve 248 TOSK olmayan) 280 hastadan elde edildi.

Bulgular: Tonsillektomi operasyonu sonrası genel kanama oranı %11.43 (32/280) idi. Kanama oranı <16 yaş grubunda %14.3 , ≥16 yaş grubunda %9.7 idi (p=0.246). Asistan doktor grubunda tonsillektomi operasyonu sonrası kanama oranı %6.16 iken; uzman doktor grubunda %27.53 idi (p<0.001). Tonsillektomi operasyonu sonrası kanayan hastalarda ameliyat süresi uzman doktor grubunda anlamlı olarak daha kısaydı (p=0.032). Binary Lojistik Regresyon analizi, uzman cerrah olmanın tonsillektomi operasyonu sonrası kanama için bir risk faktörü olduğunu ortaya koydu (p<0.001). Kısa operasyon süresi ise zayıf bir risk faktörüydü (p=0.048).

Sonuç: Ameliyatta daha fazla deneyim, tonsillektomi operasyonu sonrası kanama riskini azaltmaz, tam tersine; bu riski artırır. Uzman cerrahlardaki ameliyatı kısa sürede bitirme çabası, daha az dikkatli ve daha travmatik bir ameliyat yapma olasılığı bu sonuca neden olmuş olabilir.

Keywords

Tonsillektomi, tonsillektomi sonrası kanama, asistan, uzman, cerrahın deneyimi

Project Number

yok

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