The Surgical Instrument Surveillance Programme was funded by the Welsh Government and Public Health Wales. The authors have no other funding, financial relationships, or conflicts of interest to disclose
Postoperative hemorrhage following adenoidectomy†
Article first published online: 20 APR 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 6, pages 1246–1253, June 2012
How to Cite
Tomkinson, A., Harrison, W., Owens, D., Fishpool, S. and Temple, M. (2012), Postoperative hemorrhage following adenoidectomy. The Laryngoscope, 122: 1246–1253. doi: 10.1002/lary.23279
- Issue published online: 1 JUN 2012
- Article first published online: 20 APR 2012
- Manuscript Accepted: 10 FEB 2012
- Manuscript Revised: 8 FEB 2012
- Manuscript Received: 26 SEP 2011
- Level of Evidence: 2c
To examine postoperative hemorrhage following adenoidectomy.
Prospective multicenter observational study.
The Surgical Instrument Surveillance Programme (SISP) was established in 2003 to monitor tonsil and adenoid surgery in all hospitals in Wales. Data were examined between April 1, 2003 and June 30, 2008, for risk factors that may contribute to primary (R1) or secondary (R2) postoperative hemorrhage from the adenoid bed, of a severity sufficient to require a return to the operating room.
There were 5,588 procedures included, of which 4,225 included simultaneous tonsillectomy. The study included 2,903 (52%) males with a median age of 5.8 years (interquartile range [IQR], 4.5–7.7 years) and 2,685 (48%) females with a median age of 6.5 years (IQR, 5.0–9.1 years). There were 22 patients (0.4%; confidence interval [CI], 0.2-0.6) who returned to the operating room with a postoperative hemorrhage arising from the adenoid bed. These were exclusively R1 hemorrhage; there were no instances of R2 hemorrhage (0.0%; CI, 0.0-0.1). No specific risk factors for R1 hemorrhage could be identified. There were 38 patients in the adenotonsillectomy group who returned to operating room with a postoperative hemorrhage arising from the tonsil bed (0.5%; CI, 0.3-0.8). R1 was seen in 22 patients (0.5%; CI, 0.3-0.8) and R2 in 16 patients (0.4%; CI, 0.2-0.6).
Adenoidectomy appears to be primarily a procedure performed in childhood. The rate of R1 hemorrhage following adenoidectomy is one in 200 (0.5%) and is similar to the R1 hemorrhage rate for tonsillectomy. R2 hemorrhage following an adenoidectomy appears to be extremely rare. In children, the risk of a serious primary hemorrhage following an adenotonsillectomy is double that of either procedure when performed alone.