Post-tonsillectomy Hemorrhage: A Retrospective Study of 503 Operations

Ishida, Ryoji; Nakamura, Satoshi; Fuke, Tomohito; Yamada, Hiroyuki

doi:10.5631/jibirin.99.391

Cited by 15 publications

(3 citation statements)

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“…10 In previous studies, a bimodal pattern was noted, in which patients were most susceptible to postoperative hemorrhage on the day of surgery and approximately 1 week postoperatively. 11 12 13 Reports state that early-stage hemorrhage is attributed to an intraoperative procedure (insufficient hemostasis during surgery), whereas most late-hemorrhage cases are caused by the detachment of scabs and loosening of ligatures. 14 Other studies argue that the activation of the fibrinolytic system on the day of and approximately 1 week after surgery may also be involved.…”

Section: Discussionmentioning

confidence: 99%

Observation of Posttonsillectomy Wounds Using Endoscopy and Examination of the Postoperative Course by Wound Type

Yoshida

Furukawa

Nagase

2022

International Journal of Practical Otolaryngology

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Palatine tonsillectomy is a surgical procedure that novice otolaryngologists should master early and is taught at many medical institutions. Unfortunately, however, the transoral procedure cannot provide a large enough field of view to doctors other than the one performing the operation. Therefore, it is difficult to share the surgical field and provide real-time teaching. Dissection of the wrong layer can cause postoperative bleeding and pain. Our department uses a 70-degree, 4-mm rigid endoscope for palatine tonsillectomy, which makes it possible for preceptors to teach tonsillectomy in real time and to evaluate the condition of the postoperative wound in detail. We classified the postoperative state after tonsillectomy into three stages, based on the degree of residual subcapsular connective tissue. We assessed the association between the amount of residual subcapsular connective tissue and the underlying disease that required indication for tonsillectomy, the postoperative course, and the operation time in 33 patients who had undergone palatine tonsillectomy at our institution between May 2017 and November 2020. We found that the more the subcapsular connective tissue that remained, the less the postoperative pain and bleeding. This association suggests that conserving the subcapsular connective tissue is important. Bringing the endoscope closer to the surgical field to observe the field without blind areas enables adequate hemostasis and easy sharing of the surgical field; therefore, this method is also effective for teaching tonsillectomy to surgical trainees.

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Section: Discussionmentioning

confidence: 99%

Observation of Posttonsillectomy Wounds Using Endoscopy and Examination of the Postoperative Course by Wound Type

Yoshida

Furukawa

Nagase

2022

International Journal of Practical Otolaryngology

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“…In addition, there are concerns about patients with obesity regarding the technical difficulty in performing tonsillectomy [18]. Obesity disturbs hemostasis because a wide operating field cannot be obtained because of abundant visceral fat.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity affects wound healing, wound infection rate, and bleeding risk following various interventions [ 2 , 17 ]. In addition, there are concerns about patients with obesity regarding the technical difficulty in performing tonsillectomy [ 18 ]. Obesity disturbs hemostasis because a wide operating field cannot be obtained because of abundant visceral fat.…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index on Posttonsillectomy Hemorrhage

Hoshino

Tanigawa

Yanohara

et al. 2017

BioMed Research International

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Objective Obesity affects adverse outcomes in patients undergoing various surgeries. Tonsillectomy is one of the most common surgical procedures and posttonsillectomy hemorrhage (PTH) is the major complication in patients with tonsillectomy. However, the effect of body mass index (BMI) on posttonsillectomy bleeding episodes is not well known. This study aimed to assess the clinical association between obesity and PTH. Methods A total of 98 tonsillectomies were retrospectively reviewed. Patient charts were analyzed regarding demographic data and the indication for surgery. Patients with PTH were compared with uneventful cases. Patients were divided into three groups based on BMI: normal weight (BMI < 25 kg/m2), overweight (BMI ≥ 25 and <30 kg/m2), and obese (≥30 kg/m2). Results PTH occurred in 13% of patients with normal weight, in 23.5% of patients with overweight, and in 50% patients with obesity. The occurrence of PTH was significantly higher in patients with obesity than in those with normal weight and overweight (p = 0.008). Multivariate analysis showed that obesity was a significant factor affecting the incidence of PTH after adjusting for confounding factors. Conclusions Our findings suggest that the obese condition is independently associated with the incidence of PTH.

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口蓋扁桃摘出後の術後出血例に対する内視鏡を用いた意識下経鼻挿管の有用性

平位,

川井

2023

Nippon Jibiinkoka Tokeibugeka Gakkai Kaiho(Tokyo)

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Post-tonsillectomy Hemorrhage: A Retrospective Study of 503 Operations

Cited by 15 publications

References 0 publications

Observation of Posttonsillectomy Wounds Using Endoscopy and Examination of the Postoperative Course by Wound Type

Observation of Posttonsillectomy Wounds Using Endoscopy and Examination of the Postoperative Course by Wound Type

Effect of Body Mass Index on Posttonsillectomy Hemorrhage

口蓋扁桃摘出後の術後出血例に対する内視鏡を用いた意識下経鼻挿管の有用性

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