Talih ÖZDAŞ, Nuray BAYAR MULUK, Vedat DELİBAŞ, Mustafa Çağrı DERİCİ, Sanem Okşan ERKAN, Birgül TUHANİOĞLU, Orhan GÖRGÜLÜ, Osman Kürşat ARIKAN

Tonsillektomi sonrası kanama: Cerrahi deneyimin etkisi

Amaç: Çalışmamızda cerrahın deneyimi ile tonsillektomi operasyonu sonrası kanama (TOSK) arasındaki ilişkiyi literatür eşliğinde tartışmayı ve araştırmayı amaçladık. Materyal ve Metot: Retrospektif veriler, asistan veya uzman cerrahlar tarafından tonsillektomi operasyonu uygulanan (32 TOSK olan ve 248 TOSK olmayan) 280 hastadan elde edildi. Bulgular: Tonsillektomi operasyonu sonrası genel kanama oranı %11.43 (32/280) idi. Kanama oranı <16 yaş grubunda %14.3 , ≥16 yaş grubunda %9.7 idi (p=0.246). Asistan doktor grubunda tonsillektomi operasyonu sonrası kanama oranı %6.16 iken; uzman doktor grubunda %27.53 idi (p<0.001). Tonsillektomi operasyonu sonrası kanayan hastalarda ameliyat süresi uzman doktor grubunda anlamlı olarak daha kısaydı (p=0.032). Binary Lojistik Regresyon analizi, uzman cerrah olmanın tonsillektomi operasyonu sonrası kanama için bir risk faktörü olduğunu ortaya koydu (p<0.001). Kısa operasyon süresi ise zayıf bir risk faktörüydü (p=0.048). Sonuç: Ameliyatta daha fazla deneyim, tonsillektomi operasyonu sonrası kanama riskini azaltmaz, tam tersine; bu riski artırır. Uzman cerrahlardaki ameliyatı kısa sürede bitirme çabası, daha az dikkatli ve daha travmatik bir ameliyat yapma olasılığı bu sonuca neden olmuş olabilir.

Anahtar Kelimeler:

Tonsillektomi, tonsillektomi sonrası kanama, asistan, uzman, cerrahın deneyimi

Post-tonsillectomy bleeding: The effect of surgical experience

Aim: We aimed to discuss and investigate the relationship between the surgeon's experience and post-tonsillectomy bleeding (PTB) in the light of the literature. Methods: The retrospective data was obtained from 280 patients who underwent tonsillectomy (32 PTB and 248 no-PTB) operated by residents or consultant surgeons. Results: The overall bleeding rate after tonsillectomy was 11.43% (32/280). The bleeding rate was 14.3% in the <16 age group and 9.7% in the ≥16 age group (p=0.246). While the rate of bleeding after tonsillectomy operation was 6.16% in the resident group; it was 27.53% in the consultant group (p<0.001). In patients who bled after tonsillectomy operation, the operation time was significantly shorter in the consultant group (p=0.032). Binary Logistic Regression analysis revealed that being a consultant surgeon is a risk factor for bleeding after tonsillectomy operation (p<0.001). Short operation time was a weak risk factor (p=0.048). Conclusions: More experience in surgery does not decrease the risk for PTB, quite the reverse, it increases the PTB risk. The effort to finish surgery in a short time, and possibility of performing a less careful and more traumatic surgery might have caused this result.

Keywords:

Tonsillectomy, post-tonsillectomy bleeding, resident, consultant, surgeon’s experience,

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