Post-tonsillectomy bleeding: Our 10-year experience

Yıl 2017, Cilt: 27 Sayı: 1, 1 - 9, 05.03.2017

Aslı Çakır Cafer Boran Yüksel Olgun Taner Kemal Erdağ

Öz

Objectives: This study aims to evaluate the characteristics of the patients who were admitted due to the post-tonsillectomy bleeding and treated and to investigate related risk factors. Patients and Methods: A total of 40 patients 19 males, 21 females; mean age: 18.2 years; range, 2 to 48 years who were admitted to our clinic with the complaint of bleeding in the tonsil region following tonsillectomy/adenotonsillectomy and treated between January 2005 and December 2015 were included. Post-tonsillectomy bleeding was evaluated in terms of age, gender, indication and method of tonsillectomy, amount and time of bleeding, hemoglobin level, bleeding etiology, interventions applied, blood transfusion requirement, comorbidities, and recurrences. Results: Five patients were admitted with primary bleeding, while the remaining patients were admitted with secondary bleeding. Five patients experienced recurrent bleeding. The incidence of bleeding was found to be higher in the age group of 5-16 years and adults. The gender, the method of tonsillectomy, and the expertise degree of the surgeon had no effect on the bleeding complication. Bleeding was more commonly seen in case of tonsillectomies with an infectious indication, while infectious causes were the most common causes of bleeding etiology. Eighteen patients were treated conservatively, eight received silver nitrate cauterization, 10 received suturing, and four received suturing + bipolar cauterization. Five patients required blood transfusion. There was no mortality. Conclusion: Post-tonsillectomy bleeding is one of the most serious complications of the tonsillectomy. Preventative strategies and careful management are of utmost importance to avoid additional comorbidities and mortality.

Anahtar Kelimeler

Adenotonsillectomy, bleeding, postoperative complication, tonsillectomy

Tonsillektomi sonrası kanama: 10 yıllık deneyimimiz

Öz

Amaç: Bu çalışmada, tonsillektomi sonrası kanama ile başvurup tedavileri yapılmış hastaların özellikleri değerlendirildi ve ilişkili risk faktörleri araştırıldı.Hastalar ve Yöntemler: Ocak 2005 - Aralık 2015 tarihleri arasında tonsillektomi/adenotonsillektomi sonrası tonsil lojundan kanama yakınmasıyla kliniğimize başvuran ve tedavi edilen toplam 40 hasta 19 erkek, 21 kadın; ort. yaş 18.2 yıl; dağılım 2-48 yıl çalışmaya alındı. Tonsillektomi sonrası kanama yaş, cinsiyet, tonsillektomi endikasyonu ve yöntemi, kanama zamanı ve miktarı, hemoglobin düzeyi, kanama etyolojisi, uygulanan girişimler, kan transfüzyonu gereksinimi, eşlik eden hastalıklar ve nüksler açısından değerlendirildi.Bulgular: Beş hasta primer kanama ile başvururken, diğer hastalar sekonder kanama ile başvurdu. Beş hastada nüks kanama yaşandı. Kanama sıklığı 5-16 yaş grubu ve erişkin hastalarda daha fazla bulundu. Cinsiyet, tonsillektomi yöntemi ve cerrahın uzman olmasının kanama komplikasyonu üzerine etkisi gösterilemedi. Enfeksiyöz endikasyonlu tonsillektomilerde daha sık kanama komplikasyonu görülürken, kanama etyolojisinde de en sık enfeksiyöz nedenler saptandı. Hastalardan 18’i konservatif olarak tedavi edilirken, sekizine gümüş nitrat koterizasyon, 10’una sütürasyon ve dördüne sütürasyon + bipolar koterizasyon uygulandı. Beş hastada kan transfüzyou gerekti. Mortalite yaşanmadı.Sonuç: Tonsillektomi sonrası kanama, en ciddi tonsillektomi komplikasyonlarından biridir. İlave komorbiditeler ve mortaliteyi önlemek için önleyici stratejiler ve dikkatli tedavi büyük önem arz etmektedir

Anahtar Kelimeler

Adenotonsillektomi, kanama, ameliyat sonrası komplikasyon, tonsillektomi

Kaynakça

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