Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1543-1553
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1543
Primary and secondary postoperative hemorrhage in pediatric tonsillectomy
Bin Xu, Hai-Yan Jin, Ke Wu, Cao Chen, Li Li, Yang Zhang, Wei-Zhong Gu, Chao Chen
Bin Xu, Cao Chen, Yang Zhang, Department of Otorhinolaryngology-Head and Neck Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, Zhejiang Province, China
Hai-Yan Jin, Department of Anesthesiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, Zhejiang Province, China
Ke Wu, Li Li, Department of Operating Room, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, Zhejiang Province, China
Wei-Zhong Gu, Department of Pathology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, Zhejiang Province, China
Chao Chen, Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, Zhejiang Province, China
Author contributions: Xu B designed and performed the research and wrote the manuscript; Jin HY designed the research and supervised the report; Wu K, Chen C, Li L and Zhang Y gathered data; Gu WZ and Chen C provided pathologic and radiological data; all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Children's Hospital, Zhejiang University School of Medicine (Approval No. 2020-IRB-061).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Xu, MAMS, Attending Doctor, Department of Otorhinolaryn-gology-head and Neck Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No. 3333 Binsheng Road, Hangzhou 310052, Zhejiang Province, China. xubinent@zju.edu.cn
Received: August 4, 2020
Peer-review started: August 4, 2020
First decision: December 14, 2020
Revised: December 27, 2020
Accepted: January 20, 2021
Article in press: January 20, 2021
Published online: March 6, 2021
Processing time: 208 Days and 13.8 Hours
ARTICLE HIGHLIGHTS
Research background

Tonsillectomy is the most common procedure for pediatric recurrent acute tonsillitis and tonsillar enlargement that contributes to obstructive sleep apnea hypopnea syndrome. Postoperative hemorrhage of tonsillectomy is a life-threatening compli-cation.

Research motivation

To improve the management of postoperative hemorrhage of tonsillectomy.

Research objectives

To identify the risk factors that may contribute to primary and secondary post-operative hemorrhage in pediatric tonsillectomy.

Research methods

A retrospective analytical study was performed, which included clinical data from 5015 consecutive patients who underwent tonsillectomy from January 2009 to December 2018. Characteristics of the patients from the primary bleeding group and the secondary bleeding group were compared with those of the nonbleeding group separately.

Research results

The method of tonsillectomy and experience of the surgeon were significantly associated with primary hemorrhage, while age and time of onset were significantly associated with secondary hemorrhage. There was a significant difference in the intervention measures between the primary bleeding group and the secondary bleeding group.

Research conclusions

Coblation tonsillectomy and junior surgeons contribute to the tendency for primary hemorrhage. Age and time of onset are responsible for secondary hemorrhage.

Research perspectives

The incidence rate of post-tonsillectomy hemorrhage is low, and lethal hemorrhage rarely occurs. The risks of postoperative hemorrhage should be given more attention.