Retrospective study on the occurrence of post-operative haemorrhage after adenectomy and tonsillectomy

Introduction:

Due to the possible serious complications of bleeding after adenotonsillectomy, a preoperative minimization of risks by identifying coagulation disorders as well as the detection of congenital blood-clotting anomalies are essential.

Methods:

A retrospective analysis of pseudonymised data of 308 children and adolescents of the University ENT Clinic Halle (Saale) was made. In particular, the preoperative diagnostics on the basis of a specific anamnesis sheet for the parents and, depending on their abnormalities, the serological coagulation diagnostics of the patients who underwent tonsillectomy or adenotonsillectomy were examined regarding the bleeding complications.

Results:

A correlation could not be demonstrated between bleeding complications and abnormalities in the preoperative parental anamnesis sheets, preoperative medication, duration of surgery, intraoperative hemostasis, intraoperative complications and anesthetic particularity.

A positive correlation could be found between the personal history of bleeding incidents and the presence of pathological lab results.

Also a seasonal accumulation was noticed. There were more bleeding incidents detected in spring and autumn. Children whose parents were affected by the von-Willebrand syndrome (vWS) showed more frequent bleeding incidents. In these cases boys showed a higher number of post-operative haemorrhage than girls did. The amount of incidences of vWS in this investigated group was higher than in the average of population.

Conclusion:

This study showed that the combination of a detailed standardized personal anamnesis with specific coagulation lab parameters is significant in terms of the presence of a vWS with expected bleeding complications. In these cases, further lab diagnostics are essential.

Publication History

Publication Date:
18 April 2018 (online)