A preliminary study of the secondary postoperative haemorrhage in pediatric coblation adenotonsillectomy / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare secondary postoperative haemorrhage rate of coblation with the conventional pediatric adenotonsillectomy. And to analyze possible reasons which cause the secondary bleeding after coblation adenotonsillectomy.</p><p><b>METHODS</b>A retrospective study was applied to compare the secondary postoperative haemorrhage rate and the bleeding moment between two groups in which 1-14 years old children from April 2005 to September 2009 in Guangzhou Children's Hospital were included. Group A was pediatric patients who had conventional adenoidectomy and/or tonsillectomy (dissection, without heat damage to the tissue) from April 2005 to July 2006 in Department of Otorhinolaryngology. Group B was pediatric patients who had coblation adenoidectomy and/or tonsillectomy from April 2008 to September 2009 in Department of Otorhinolaryngology.</p><p><b>RESULTS</b>Two of 484 cases in group A had secondary postoperative bleeding, the rate was 0.4%. One happened 2 days after operation, another after 3 days. Eleven of 502 cases in group B had secondary postoperative bleeding, the rate was 2.2%. Secondary bleeding happened 2 to 12 days after surgery, median 6.0 days. The secondary postoperative haemorrhage rate of operating by the freshman was 2.6%(10/385), and it was 0.9%(1/117) by the senior. The rate of secondary bleeding was higher in group B than group A (chi(2) = 5.987, P < 0.05). There was no significant difference of secondary bleeding time in both groups (Mann-Whitney U score was 2.500, P > 0.05). Six of 13 cases who had secondary bleeding suffered wound or upper respiratory tract infection. Three of 13 ate inappropriately after the operation.</p><p><b>CONCLUSIONS</b>Pediatric coblation adenotonsillectomy is a new method. The most possible reasons of secondary bleeding are poor surgery skills and ill experience. And, infection, inappropriate eating after the operation may be the other reasons of secondary bleeding.</p>