R Mösges1, K Albrecht, M Hellmich, S Allekotte, M Vogtel. 1. Institut für Medizinische Statistik, Informatik und Epidemiologie (IMSIE), Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland. Ralph@Moesges.DE
Abstract
BACKGROUND: With over 100,000 cases annually, tonsillectomy is one of the most frequently performed ENT surgical procedures in Germany. Hemorrhage ranks among its serious postoperative complications. In this systematic review, we analyze hemorrhage following tonsillectomies performed using coblation technique. METHODS: Of the 135 studies identified, 38 could be included in the analysis, most being prospective randomized controlled studies. Data from 6290 patients were gathered. RESULTS: Of all tonsillectomies performed, hemorrhages occurred in 355 patients. Of these, 256 cases could be classified as 41 primary and 215 secondary hemorrhages. Overall, the total hemorrhage rate for the coblation procedure was 4.9% (95%-CI: 0.044-0.054) for the fixed effects model. CONCLUSION: Significantly higher rates of postoperative hemorrhage were found in a few studies, yet they were well above the 95% confidence interval of 4.4-5.4% of the literature. These studies could possibly be interpreted in terms of an autodidactic learning process. As with any surgical technique, proper training is essential.
BACKGROUND: With over 100,000 cases annually, tonsillectomy is one of the most frequently performed ENT surgical procedures in Germany. Hemorrhage ranks among its serious postoperative complications. In this systematic review, we analyze hemorrhage following tonsillectomies performed using coblation technique. METHODS: Of the 135 studies identified, 38 could be included in the analysis, most being prospective randomized controlled studies. Data from 6290 patients were gathered. RESULTS: Of all tonsillectomies performed, hemorrhages occurred in 355 patients. Of these, 256 cases could be classified as 41 primary and 215 secondary hemorrhages. Overall, the total hemorrhage rate for the coblation procedure was 4.9% (95%-CI: 0.044-0.054) for the fixed effects model. CONCLUSION: Significantly higher rates of postoperative hemorrhage were found in a few studies, yet they were well above the 95% confidence interval of 4.4-5.4% of the literature. These studies could possibly be interpreted in terms of an autodidactic learning process. As with any surgical technique, proper training is essential.
Authors: A Simon Carney; Penelope K Harris; Patricia L MacFarlane; Simon Nasser; Adrian Esterman Journal: Otolaryngol Head Neck Surg Date: 2008-02 Impact factor: 3.497
Authors: K Scheckenbach; H Bier; T K Hoffmann; J P Windfuhr; M Bas; H-J Laws; C Plettenberg; M Wagenmann Journal: HNO Date: 2008-03 Impact factor: 1.284