Avoidance of Primary Post-Tonsillectomy Hemorrhage in a Teaching Program

Conley, Stephen F.; Ellison, Matthew D.

doi:10.1097/00132586-199910000-00047

Cited by 2 publications

(3 citation statements)

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“…As a result, we could not comment on patient factors or potential confounders that contributed to bleeding episodes‐ particularly in those requiring surgical intervention from severe PTB. Additionally, we reported a PTB rate in both cohorts that were above the commonly reported trends in the literature 6‐8 . We defined a PTB as any bleed post T/A regardless of timing, quantity, or intervention needed for the sake of completeness.…”

Section: Discussionmentioning

confidence: 87%

“…Although commonly performed, T/A is not without its own set of post‐surgical complications 5 . Post‐tonsillectomy bleed (PTB) is a serious complication and is reported to occur in 3%‐5% of pediatric cases 6‐8 . Additionally, patients with a known bleeding disorder (BD) may have a higher risk of developing PTB and should be strictly co‐managed with a hematologist to prevent this dangerous complication 9 …”

Section: Introductionmentioning

confidence: 99%

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Postoperative tonsil/adenoidectomy bleeding management in patients with diagnosed bleeding disorders

Pai

Desai

Stein

et al. 2021

Laryngoscope Investig Oto

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Objective Tonsil/adenoidectomy (T/A) is a commonly performed procedure with an average post‐tonsillectomy bleed (PTB) rate between 3 and 5%. Patients with bleeding disorders (BDs) are believed to have an increased risk of PTB. We hypothesize that our medical management of BD patients using a combination of DDAVP/antifibrinolytic agents has a similar PTB rate to control patients. This study suggests a standardized protocol for patients with BDs to avoid PTB. Methods A retrospective cohort study was completed for patients with BD who underwent tonsillectomy or T/A at Promedica Toledo or Flower Hospital between 2013 and 2020. Exclusion criteria included incomplete records, diagnosis of BD after surgery, and inability to find age and sex matched control. We defined the control group as patients who underwent T/A without BD. The following variables were collected: age, sex, medical history, BD severity, medications, type of surgery, indication for surgery, estimated blood loss (EBL), pre/postoperative medications, PTB status, and post‐PTB intervention. Results A total of 164 patient charts were reviewed. There were 82 patients in both cohorts. The BDs represented were platelet function disorder (80.5%), von Willebrand disease (14.6%), and others such as Factor VII and IX deficiency (4.9%). Of the BD patients included, 13.4% had severe disease. There was no significant difference between the age, sex, EBL, and PTB rates. Of the 8 BD patients with PTB, 62% bled 9‐10 days postoperatively and none had severe disease. Conclusion Our protocol to prevent PTB in patients with BDs produced similar bleed rates to control patients in this study. Further studies are required to assess postoperative length of antifibrinolytic treatment in BD patients. Level of Evidence III.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Postoperative tonsil/adenoidectomy bleeding management in patients with diagnosed bleeding disorders

Pai

Desai

Stein

et al. 2021

Laryngoscope Investig Oto

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“…Bleeding has been divided into two categories; primary, occurring less than 24 hour after surgery and secondary, occurring more than 24 hour, commonly 5-10 days after the operation. Secondary hemorrhage has a reported rate of 3-5% leading to re-admission to hospital [7,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison between Post-tonsillectomy Bleeding of Three Different Techniques in Children

Alzuwayed¹,

Qattan²

2015

Trop Med Surg

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Introduction: Post-tonsillectomy bleeding remains the most serious complication of tonsillectomy. The rate of post tonsillectomy bleeding varies with different technique. The common used techniques are the bipolar, monopolar and cold.Methods: This was a retrospective case series study based on chart review of children under 14 years who underwent tonsillectomy during the period between January 2010 to December 2011 at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia -ENT department. The charts of all the patients were reviewed by the student and the data form filled for included patients for the age, gender, indications for tonsillectomy, previous surgery, medications, admission type, technique used which are the bipolar, monopolar and cold technique and complications.Results: Out of 60 patients reviewed, post tonsillectomy bleeding was reported in 16 (27%). Indications for tonsillectomy were six indications and most common one was recurrent adenotonsillitis in 27 (46%).Intraoprative bleeding was 8 cases (13%) which was the most common type of bleeding and there was no significant difference in post tonsillectomy bleeding between the three techniques (p=0.62). Conclusion:The result showed that there was no significant difference in post tonsillectomy bleeding between the three techniques.

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Avoidance of Primary Post-Tonsillectomy Hemorrhage in a Teaching Program

Cited by 2 publications

References 0 publications

Postoperative tonsil/adenoidectomy bleeding management in patients with diagnosed bleeding disorders

Postoperative tonsil/adenoidectomy bleeding management in patients with diagnosed bleeding disorders

Comparison between Post-tonsillectomy Bleeding of Three Different Techniques in Children

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