囊内扁桃体切除术和全扁桃体切除术围手术期呼吸并发症：有区别吗？

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-02-01 DOI:10.1016/j.ijporl.2025.112216

Shraddha Mukerji , Joshua Bedwell , Ava Berrier , Carolyn Chen , Kathleen Hosek , Rahul G. Baijal

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引用次数: 0

摘要

目的：主要目的是确定因睡眠呼吸障碍或阻塞性睡眠呼吸暂停而接受囊内扁桃体切除术的儿童与接受全扁桃体切除术的儿童围手术期呼吸并发症的差异。方法：纳入2015年11月至2017年12月、2016年5月至2020年7月因睡眠呼吸障碍或阻塞性睡眠呼吸暂停而接受全扁桃体切除术和囊内扁桃体切除术的所有儿童。结果：2408例患者行全扁桃体切除术，410例患者行囊内扁桃体切除术。在未匹配队列中，囊内扁桃体切除术和全扁桃体切除术的主要呼吸系统并发症发生率分别为13.9%和8.9%；在匹配队列中，囊内扁桃体切除术和全扁桃体切除术的发生率分别为13.8%和10.5%。手术技术对非匹配组中严重（OR:0.969, 95% CI:0.596-1.573, p = 0.8979）和轻微（OR:0.9, 95% CI:0.431-1.878, p = 0.7785）呼吸并发症的影响均无统计学意义，对匹配组中严重（OR:0.996, 95% CI:0.353 - 2.809, p = 0.9944）和轻微（OR:1.5, 95% CI:0.66-3.612, p = 0.31）呼吸并发症的影响也无统计学意义。在未匹配队列中，与主要围手术期呼吸并发症发生率增加相关的因素包括种族（黑人或非裔美国人）（or:1.768, 95% CI:1.298-2.409, p= 0.0038），反应性气道疾病(or:1.814, 95% CI:1.39-2.367, p=结论：接受囊内扁桃体切除术与全扁桃体切除术的儿童围手术期呼吸并发症无差异。

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Perioperative respiratory complications in intracapsular tonsillectomy and total tonsillectomy: Is there a difference?

Purpose

The primary objective was to determine any difference in perioperative respiratory complications in children undergoing intracapsular tonsillectomy versus those undergoing total tonsillectomy for sleep-disordered breathing or obstructive sleep apnea.

Methods

All children undergoing total tonsillectomy from November 2015 to December 2017 and intracapsular tonsillectomy from May 2016 to July 2020 for sleep-disordered breathing or obstructive sleep apnea were included in the study.

Results

2408 patients underwent total tonsillectomy whereas 410 patients underwent intracapsular tonsillectomy. The incidence of major respiratory complications was 13.9 % for intracapsular tonsillectomy and 8.9 % for total tonsillectomy in an unmatched cohort and 13.8 % for intracapsular tonsillectomy and 10.5 % for total tonsillectomy in a matched cohort. Surgical technique was not significant for both major (OR:0.969, 95 % CI:0.596–1.573, p = 0.8979) and minor (OR 0.9, 95 % CI:0.431–1.878, p = 0.7785) respiratory complications in the unmatched cohort and also not significant for major (OR:0.996, 95 % CI:0.353 2.809, p = 0.9944) and minor (OR:1.5, 95 % CI:0.66–3.612, p = 0.31) respiratory complications in the matched cohort. Factors associated with an increased incidence of major perioperative respiratory complications in the unmatched cohort included race (Black or African American) (OR:1.768, 95 % CI:1.298–2.409, p = 0.0038), reactive airway disease (OR:1.814, 95 % CI:1.39–2.367, p=<0.0001), and an upper respiratory infection (OR:1.631, 95 % CI:1.095–2.431, p = 0.0161) whereas reactive airway disease (OR:3.596,95 % CI:1.217–10.621, p=<0.0206), an upper respiratory infection (OR:5.779, 95 % CI:1.392–23.99, p = 0.0157), and the presence of obstructive sleep apnea (OR:4.174, 95 % CI:1.242–14.025, p = 0.0208) were significant in the matched cohort.

Conclusion

There was no difference in perioperative respiratory complications in children undergoing intracapsular tonsillectomy versus total tonsillectomy.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.