Prevalence of Early Postoperative Complications and Associated Factors Following Adenotonsillectomy Among Children Attending at Bugando Medical Centre in Mwanza Tanzania.
- Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024.
- 43 Pages Includes References
Background information:
Adenotonsillectomy is a surgical removal of both the adenoids and the tonsils. Studies have shown that The most frequent complication was respiratory compromise (9.4%), followed by secondary hemorrhage (2.6%) (1). A study in United States of America (USA) done by Spencer et al revealed that among the patients whose records were reviewed, 80 (93.0%) did not experience any intraoperative or postoperative complication. Dehydration was the most common complication and was the cause of all documented readmissions (4.7%) in our patients who ranged in age from 14 to 30 months(2). In a study by Liu et al done in China revvealed that, 11.2% had postoperative respiratory complications necessitating a medical intervention. 80.6% required an oropharyngeal or nasopharyngeal airway. 69.4% experienced multiple episodes of desaturation, and 61.1% of cases had respiratory complications in the post anesthesia care unit(3). Studies have shown that the most frequent early complications after AT are respiratory compromise and secondary hemorrhage. Based on the current limited evidence, children with OSA appear to have more respiratory complications. Conversely, hemorrhage appears to be more frequent in children without OSA(4). The analyzed data show a higher rate of early complications and unplanned admissions in children under age 4(5). A study by Amoils et al done in South Africa revealed that large numbers of pediatric patients undergo Tonsillectomy & Adenoidectomy in ambulatory settings despite higher rates of complications in younger patients and patients with more co-morbidities (6). In a study by Keseru et al done in Romania revealed that morbidity and mortality appeared more frequently in moderate and severe OSA compared to non‐OSA patients (7). Gallagher et al in Ireland revealed that surgical techniques e.g. microdebrider intracapsular tonsillectomy is associated with lower rates of post-tonsillectomy hemorrhage and dehydration when compared to coblation and electrocautery complete tonsillectomy technique(8).In a study by Gehrke et al done in Germany revealed that young age , low body weight, obstructive sleep apnea, pre-existing craniofacial or syndromal disorders and adenotonsillectomy, compared with adenoidectomy alone, were identified as risk factors for complications during or after surgery(10). A study by Kristina et al revealed that follow up telephone call is safe and cost effective method of post-operative management of pediatric patients who have undergone adenotonsillectomy and that this method of follow up is also desirable to parents(11). Spencer et al. revealed that Criteria for inpatient admission for children younger than 3 years should be based on preoperative and postoperative clinical evaluation of the patient and an evaluation of the family resources for adequately caring for young children at home in the postoperative period(3).In a study by Theilhaber et al done in Australia reported that routine post-operative ICU care for high risk children may be avoided if prolonged monitoring in the post anethesthetic care unit is possible, with admission to ICU reserved for high-risk children with an early adverse events (12).
Wurzburg Road 35, Premises, Post Code: 33102 | P. O. Box 1464 Mwanza, Tanzania | Phone: (255) 28-298-3384 | Fax: (255) 28-298-3386 | Email: vc@bugando.ac.tz | Website: www.bugando.ac.tz