Posttonsillectomy bleeding: Difference between children and adults

Yıl 2019, , 365 - 369, 29.08.2019

Ceyhun Aksakal

https://doi.org/10.35440/hutfd.541040

Öz

Background: To examine and compare the characteristics of
posttonsillectomy bleeding (PTB) in adult and pediatric patients who underwent
tonsillectomy or adenotonsillectomy.

Methods: In this retrospective cross-sectional study,
medical records of 421 patients who underwent bipolar elecrtocautery with
tonsillectomy or adenotonsillectomy in Tokat State Hospital between 1 January
2014 and 30 September 2018 were examined. The characteristics of the patients
such as age, gender, surgical procedures performed, the day of PTB, necessity
of blood transfusion for PTB, type of hemostasis in PTB were evaluated.

Results: PTB was 6.10% in adults (age≥16) and 2.41% in children (age <16). While
PTB was seen in an adult patient, primary PTB was not seen in pediatric
patients. Secondary PTB was seen in eight (6.10%) patients in adults and in
seven (2.41%) patients in children. The incidence of PTB was significantly
higher in adults than in children (p <0.05). The need for blood transfusion
was in two adult patients with PTB, but none of the PTBs required blood
transfusion in pediatric patients. Spontaneous hemostasis was seen in three of
seven children with PTB, and hemostasis was performed in four patients under
general anesthesia. Spontaneous hemostasis was observed in one of the nine
adult patients with PTB. In six patients, hemostasis was performed under
general anesthesia.

Conclusions: PTB is more common in adults than in
children. In general, the most common days of PTB are postoperative 6.-8. days.
Spontaneous hemostasis is more common in children than in adults, whereas in
children, PTB has a higher rate of hemostasis under general anesthesia.

Posttonsillektomi kanama: Çocuklar ve yetişkinler arasındaki farklar

Öz

Amaç: Tonsillektomi veya adenotonsillektomi
yapılan erişkin ve çocuk hastalarda görülen posttonsillektomi kanamaların (PTK)
özelliklerini incelemek ve karşılaştırmak

Materyal
ve Metod:
Bu retrospektif kesitsel çalışmada 1 Ocak 2014 ile 30 Eylül 2018 arasında Tokat
Devlet Hastanesinde bipolar elektrokoter ile tonsillektomi veya
adenotonsillektomi yapılan 421 hastanın elektronik medikal kayıtları incelendi.
Hastaların yaş, cinsiyet, uygulanan cerrahi prosedürler, PTK' nın gerçekleştiği
gün, PTK için kan transfüzyonu gerekliliği, PTK da hemostazın tipi gibi
özellikleri değerlendirildi.

Bulgular: PTK, erişkinlerde (yaş≥16) 
%6,10, çocuklarda (yaş<16) % 2,41 oranında görüldü. Primer PTK bir
erişkin hastada görülürken,çocuk hastalarda primer PTK görülmedi. Sekonder PTK
erişkinlerde sekiz  (%6,10) hastada
görülürken, çocuklarda yedi (%2,41) hastada görüldü. PTK insidansı erişkinlerde
çocuklara göre anlamlı düzeyde yüksek bulundu (p<0,05). Kan tranfüzyonu
ihtiyacı iki erişkin PTK’lı hastada olurken, çocuk hastalardaki PTK’ ların
hiçbirinde kan transfüzyonu ihtiyacı olmadı. PTK görülen yedi çocuk hastanın
üçünde spontan hemostaz görülürken, dört hastada hemostaz genel anestezi
altında sağlandı. PTK görülen 9 erişkin hastanın birinde spontan hemostaz
görüldü. Altı hastada ise hemostaz genel anestezi altında sağlandı.

Sonuç: Erişkinlerde PTK çocuklara göre daha
fazla görülmektedir. Genel olarak PTK nın en sık görüldüğü günler postoperatif
6.-8. Günler arasıdır. Spontan hemostaz çocuklarda erişkinlere göre daha fazla
görülürken, çocuklardaki PTK da genel anestezi altında hemostaz oranı daha
yüksektir. 

Anahtar Kelimeler

Posttonsillektomi kanama, Tonsillektomi, Çocuk, Erişkin

Kaynakça

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