Thomas Wilhelm, Jan Wittlinger, Robert Georgiew, Christian Güldner, Stephan Hoch, Afshin Teymoortash, Thomas Günzel, Petar Stankovic
{"title":"显微镜辅助冷钢扁桃体切除术能降低术后出血的风险吗?前瞻性队列研究的结果。","authors":"Thomas Wilhelm, Jan Wittlinger, Robert Georgiew, Christian Güldner, Stephan Hoch, Afshin Teymoortash, Thomas Günzel, Petar Stankovic","doi":"10.1155/2017/8430907","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Posttonsillectomy hemorrhage (PTH) is the most feared complication. Dissection near the tonsillar capsule under microscopic view (TE<sub>mic</sub>) could be assumed to decrease PTH compared to traditional tonsillectomy (TE<sub>trad</sub>).</p><p><strong>Methods: </strong>In this study, patients were evaluated with respect to the need for surgical control (R/N: return/no return to theater (RTT): the day of surgery [0] or thereafter [1]). The findings at resection site and pain were measured.</p><p><strong>Results: </strong>869 patients were included (183 TE<sub>mic</sub>; 686 TE<sub>trad</sub>). PTH requiring RTT was not seen in the TE<sub>mic</sub> group on the day of surgery (R0) while PTH requiring RTT subsequently (R1) was seen in 1.1% of the cases. In the TE<sub>mic</sub> group, hemorrhages without a need for surgical control were observed in 0.6% (N0) and 3.4% (N1), respectively. The corresponding rates for TE<sub>trad</sub> were as follows: R0, 0.3%; R1, 1.7%; N0, 0.6%; and N1, 3.6% (<i>p</i> > 0.05). Postoperative edema and local infection at resection site were proven to be predictive of PTH (<i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Microscope assistance in tonsillectomy did not statistically have an influence on the PTH even though there was a trend towards lower PTH rate in the TE<sub>mic</sub> group. Benefit for TE<sub>mic</sub> was observed in high-volume and long experienced surgeons.</p>","PeriodicalId":32361,"journal":{"name":"International Journal of Otolaryngology","volume":"2017 ","pages":"8430907"},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/8430907","citationCount":"2","resultStr":"{\"title\":\"Does Microscope Assistance in Cold Steel Tonsillectomy Reduce the Risk of Postoperative Hemorrhage? Results of a Prospective Cohort Study.\",\"authors\":\"Thomas Wilhelm, Jan Wittlinger, Robert Georgiew, Christian Güldner, Stephan Hoch, Afshin Teymoortash, Thomas Günzel, Petar Stankovic\",\"doi\":\"10.1155/2017/8430907\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Posttonsillectomy hemorrhage (PTH) is the most feared complication. Dissection near the tonsillar capsule under microscopic view (TE<sub>mic</sub>) could be assumed to decrease PTH compared to traditional tonsillectomy (TE<sub>trad</sub>).</p><p><strong>Methods: </strong>In this study, patients were evaluated with respect to the need for surgical control (R/N: return/no return to theater (RTT): the day of surgery [0] or thereafter [1]). The findings at resection site and pain were measured.</p><p><strong>Results: </strong>869 patients were included (183 TE<sub>mic</sub>; 686 TE<sub>trad</sub>). PTH requiring RTT was not seen in the TE<sub>mic</sub> group on the day of surgery (R0) while PTH requiring RTT subsequently (R1) was seen in 1.1% of the cases. In the TE<sub>mic</sub> group, hemorrhages without a need for surgical control were observed in 0.6% (N0) and 3.4% (N1), respectively. The corresponding rates for TE<sub>trad</sub> were as follows: R0, 0.3%; R1, 1.7%; N0, 0.6%; and N1, 3.6% (<i>p</i> > 0.05). Postoperative edema and local infection at resection site were proven to be predictive of PTH (<i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Microscope assistance in tonsillectomy did not statistically have an influence on the PTH even though there was a trend towards lower PTH rate in the TE<sub>mic</sub> group. Benefit for TE<sub>mic</sub> was observed in high-volume and long experienced surgeons.</p>\",\"PeriodicalId\":32361,\"journal\":{\"name\":\"International Journal of Otolaryngology\",\"volume\":\"2017 \",\"pages\":\"8430907\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2017/8430907\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Otolaryngology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2017/8430907\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/8/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Otolaryngology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2017/8430907","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/8/8 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Does Microscope Assistance in Cold Steel Tonsillectomy Reduce the Risk of Postoperative Hemorrhage? Results of a Prospective Cohort Study.
Background: Posttonsillectomy hemorrhage (PTH) is the most feared complication. Dissection near the tonsillar capsule under microscopic view (TEmic) could be assumed to decrease PTH compared to traditional tonsillectomy (TEtrad).
Methods: In this study, patients were evaluated with respect to the need for surgical control (R/N: return/no return to theater (RTT): the day of surgery [0] or thereafter [1]). The findings at resection site and pain were measured.
Results: 869 patients were included (183 TEmic; 686 TEtrad). PTH requiring RTT was not seen in the TEmic group on the day of surgery (R0) while PTH requiring RTT subsequently (R1) was seen in 1.1% of the cases. In the TEmic group, hemorrhages without a need for surgical control were observed in 0.6% (N0) and 3.4% (N1), respectively. The corresponding rates for TEtrad were as follows: R0, 0.3%; R1, 1.7%; N0, 0.6%; and N1, 3.6% (p > 0.05). Postoperative edema and local infection at resection site were proven to be predictive of PTH (p = 0.007).
Conclusion: Microscope assistance in tonsillectomy did not statistically have an influence on the PTH even though there was a trend towards lower PTH rate in the TEmic group. Benefit for TEmic was observed in high-volume and long experienced surgeons.
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