Adenotonsillectomy Complications: A Meta-analysis

被引:142
作者
Canto, Graziela De Luca [1 ,2 ]
Pacheco-Pereira, Camila [2 ]
Aydinoz, Secil [3 ]
Bhattacharjee, Rakesh [4 ]
Tan, Hui-Leng [5 ]
Kheirandish-Gozal, Leila [4 ]
Flores-Mir, Carlos [2 ]
Gozal, David [4 ]
机构
[1] Univ Fed Santa Catarina, Dept Dent, Florianopolis, SC, Brazil
[2] Univ Alberta, Fac Med & Dent, Sch Dent, Edmonton, AB T6G 2M7, Canada
[3] Gulhane Mil Med Acad, Istanbul, Turkey
[4] Univ Chicago, Dept Pediat, Pritzker Sch Med, Div Biol Sci, Chicago, IL 60637 USA
[5] Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, London, England
基金
美国国家卫生研究院;
关键词
OBSTRUCTIVE SLEEP-APNEA; POST-TONSILLECTOMY HEMORRHAGE; POSTOPERATIVE COMPLICATIONS; OUTPATIENT PROCEDURE; RISK-FACTORS; CHILDREN; ADENOIDECTOMY; PREVALENCE; ASSOCIATION; MANAGEMENT;
D O I
10.1542/peds.2015-1283
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUND AND OBJECTIVE: Complications after adenotonsillectomy (AT) in children have been extensively studied, but differences between children with and without obstructive sleep apnea (OSA) have not been systematically reported. Our objective was to identify the most frequent complications after AT, and evaluate if differences between children with and without OSA exist. METHODS: Several electronic databases were searched. A partial gray literature search was undertaken by using Google Scholar. Experts were consulted to identify any missing publications. Studies assessing complications after AT in otherwise healthy children were included. One author collected the required information from the selected articles. A second author crosschecked the collected information and confirmed its accuracy. Most of the selected studies collected information from medical charts. RESULTS: A total of 1254 studies were initially identified. Only 23 articles remained after a 2-step selection process. The most frequent complication was respiratory compromise (9.4%), followed by secondary hemorrhage (2.6%). Four studies compared postoperative complications in children with and without OSA, and revealed that children with OSA have nearly 5 times more respiratory complications after AT than children without OSA (odds ratio = 4.90; 95% confidence interval: 2.38-10.10). In contrast, children with OSA are less likely to have postoperative bleeding when compared with children without OSA (odds ratio = 0.41; 95% confidence interval: 0.23-0.74). CONCLUSIONS: 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.
引用
收藏
页码:702 / 718
页数:17
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