Primary and secondary postoperative hemorrhage in pediatric tonsillectomy
Bin Xu, Haiyan Jin, Ke Wu, Cao Chen, Li Li, Yang Zhang, Weizhong Gu, Chao Chen
Abstract
BACKGROUND: Tonsillectomy is the most common procedure for treatment of pediatric recurrent acute tonsillitis and tonsillar enlargement that contributes to obstructive sleep apnea hypopnea syndrome. Postoperative hemorrhage of tonsillectomy is a life-threatening complication. AIM: To identify the risk factors that may contribute to primary and secondary post-operative hemorrhage in pediatric tonsillectomy. METHODS: The clinical data from 5015 children, 3443 males and 1572 females, aged 1.92-17.08 years, with recurrent tonsillitis and/or tonsil hypertrophy who underwent tonsillectomy in our hospital from January 2009 to December 2018 were retrospectively collected. The variables including sex, age, time of onset, diagnosis, method of tonsillectomy, experience of surgeon, time when the surgery started and monthly average air temperature were abstracted. The patients with postoperative hemorrhage were classified into two groups, the primary bleeding group and the secondary bleeding group, and their characteristics were compared with those of the nonbleeding group separately. Statistical analysis was performed by chi-square test with SPSS 20. RESULTS: = 0.001). The lower pole and middle portion were the common bleeding sites, followed by the upper pole and palatoglossal arch. CONCLUSION: The incidence rate of post-tonsillectomy hemorrhage is low. Coblation tonsillectomy and less than 5 years' experience of surgeon contribute to the tendency for primary hemorrhage. Age and time of onset are responsible for secondary hemorrhage.