TONSİLLEKTOMİ SONRASI KANAMA: BİZMUT SUBGALLATIN ETKİSİ

Giriş: Bizmut subgallatın oral mukozal yaralar üzerine hem olumlu hem de olumsuz etkileri olduğunu bildiren çalışmalar mevcuttur. Ancak literatürde tonsillektomi sonrasında primer ve sekonder kanamaya etkisini araştıran çalışmalar güncel olmayıp çok sınırlıdır. Bu çalışmanın amacı tonsillektomi yapılan hastalarda intraoperatif olarak uygulanan bizmut subgallatın postoperatif primer ve sekonder kanamaya etkisini araştırmaktır. Yöntem ve Gereç: Mart 2011 ve Haziran 2020 tarihleri arasında genel anestezi altında tonsillektomi ve/veya adenotonsillektomi yapılan hastaların verileri retrospektif olarak taranarak 408 hasta çalışmaya dahil edildi. Bizmut subgallat uygulanan ve uygulanmayan gruplardaki hastaların primer ve sekonder kanama oranları mukayese edildi. Bulgular: Bizmut subgallat uygulaması yapılan grupta yaşları 2 ile 72 arasında değişen (9.77±10.77) 190, kontrol grubunda ise yaşları 2 ile 64 arasında değişen (11.30±10.97) 218 hasta yer almaktaydı. Her iki grupta da tonsillektomi sonrası primer kanama görülmezken bizmut subgallat grubunda 3 (%1.6), kontrol grubunda ise 7 (%3.2) hastada geç kanama görüldü. Kontrol grubunda daha fazla sayıda hastada geç kanama görülmesine rağmen istatistiksel olarak anlamlı bir farklılık bulunmadı (x2=1.131, p =0.349). Bizmut subgallat uygulamasına bağlıolarak hiç bir hastamızda komplikasyon gelişmedi. Sonuç: Tonsillektomi sırasında cerrahi alana bizmut subgallat ve epinefrin karışımı uygulamasının postoperatif dönemde primer ve sekonder kanama üzerine olumlu ya da olumsuz etkisi yoktur.

POST-TONSILLECTOMY HEMORRHAGE: THE EFFECT OF BISMUTH SUBGALLATE

Introduction: There are studies reporting that bismuth subgallate has both positive and negative effects on oral mucosal wounds. However, studies investigating the effect of primary and secondary bleeding after tonsillectomy in the literature are not current and very limited. The aim of this study is to investigate the effect of bismuth subgallate applied during tonsillectomy on primary and secondary bleeding. Methods: The data of patients who underwent tonsillectomy and/or adenotonsillectomy under general anesthesia between March 2011and June 2020 were reviewed retrospectively and 408 patients were included in the study. Primary and secondary bleeding rates of patients in groups with and without bismuth subgallate were compared. Results: In the bismuth subgallate group, there were 190 patients aged between 2 and 72 (9.77 ± 10.77), and 218 patients aged between 2 and 64 (11.30 ± 10.97) in the control group. While primary bleeding was not observed after tonsillectomy in both groups, late bleeding was observed in 3 (1.6%) patients in the bismuth subgallate group and in 7 (3.2%) patients in the control group. Although more bleeding was observed in more patients in the control group, no statistically significant difference was found (x2 = 1.131, p = 0.349). No complication developed in any of our patients due to bismuth subgallate application. Conclusion: The application of a mixture of bismuth subgallate and epinephrine to the surgical field during tonsillectomy does not have a positive or negative effect on primary and secondary bleeding in the postoperative period.

Kaynakça

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