Tonsil and vegetation surgeries at the General Hospital in Zadar 2012. - 2013.

Uvod: Tonzilektomija je najčešća operacija u dječjoj dobi. Uz tonzile se u pravilu kod djece odstranjuju i vegetacije. Odluka o tonzilektomiji unatoč postojećim smjernicama i dalje se bazira prvenstveno na iskustvu operatera i na procjeni pojedinog bolesnika. Danas se tonziloadenoidektomija ubraja u zahvate koji se izvode u jednodnevnoj kirurgiji. Ispitanici i metode: U radu je prikazano retrospektvno ispitivanje operiranih bolesnika od tonzilektomija, adenoidektomija, miringotomije te miringotomije s postavljenjem cjevčica kod bolesnika liječenih na Otorinolaringološkom odjelu Opće bolnice u Zadru, tijekom 2012-2013. godine. Ispitan je broj operiranih bolesnika, spolna i dobna distribucija oboljelih te poslijeoperativne komplikacije. Tijekom ispitivanog razdoblja operirano je 570 bolesnika metodom tzv. “hladne disekcije”. Dobiveni rezultati prikazani su grafički. Rezultati: U ispitivanoj grupi bolesnika dominirali su muškarci i činili su 53% operiranih bolesnika. Većina bolesnika operirana je u dobi između četvrte i sedme godine života. Tijekom ispitivanoga razdoblju učinjeno je 1047 operacija kod 570 bolesnika. Najčešća operacija u našoj skupini bolesnika bila je tonzilektomija koja je učinjena kod 83% bolesnika, dok je adenoidektomija učinjena kod 71% operiranih bolesnika. Intraoperativnih komplikacija nije bilo, a poslijeoperativne komplikacije javile su se kod nešto više od 6% operiranih bolesnika. Među bolesnicima najčešća poslijeoperativna komplikacija bila je krvarenje koje se javilo kod 4.38% operiranih bolesnika. Kod 0,7% od ukupnog broja operiranih bila je potrebna intraoperativna revizija bolesnika radi krvarenja. U našoj skupini bolesnika infekcija je bila najčešće povezana s krvarenjem, gotovo kod trećine bolesnika koji su imali krvarenje iz poslijeoperativne rane. Niti kod jednog bolesnika nije bila potrebna transfuzija krvi nakon poslijeoperativnog krvarenja iz rane. Krvarenje se najčešće javilo četvrtog i petog poslijeoperativnog dana. Prosječna dob bolesnika s poslijeoperativnim krvarenjem iznosila je 10 godina. Osim krvarenja kao poslijeoperativna komplikacija se javila infekcija kod 3,5% operiranih bolesnika. Zaključak: Operacije tonzila najčešće su u dobi od četvrte do sedme godine života. Među operiranima dominiraju muškarci. Od poslijeoperativnih komplikacija najčešće su krvarenje i infekcija poslijeoperativne rane, a kod trećine bolesnika s komplikacijama krvarenje i infekcija su udruženi. Samo kod 0,7% bolesnika potrebna je kirurška revizija operativne rane nakon krvarenja.Introduction: Tonsillectomy is the most frequent surgical procedure performed on children. As a rule, during tonsillectomy performed on children tonsil vegetation is removed, too. The decision on tonsillectomy despite the existing guidelines is still based primarily on the experience of the operator and the evaluation of each individual patient. Today tonsilloadenoidectomy is considered to be a day-surgery procedure. Participants and methods: The final thesis provides a retrospective research on patients who went through tonsillectomy, adenoidectomy, myringotomy and myringotomy with tube placements in patients treated on the Otorhinolaryngology department of the General Hospital in Zadar during 2012-2013. The number of operated patients, sex and age distribution, as well as postoperative complications were registered. During the research period 570 patients went through cold dissection method. The obtained results were shown graphically / on charts. Results: Men dominated in the tested group of patients and made 53% of the patients that underwent surgery. Most patients underwent surgery between the age of four and seven. During the research period 1047 surgeries were performed on 570 patients. The most frequent surgery procedure in our patient group was tonsillectomy performed on 83% of patients, while adenoidectomy was performed on 71% of the operated patients. There were no interaoperative complications, and postoperative complications were recorded in slightly over 6% of the patients that underwent surgery. The most frequent postoperative complication among the patients was the bleeding which was recorded in 4.38% of the patients that underwent surgery. In 0,7 % of the total number of patients that underwent surgery interaoperative revision of the patients was necessary due to bleeding. In our patient group infection was mostly related to the bleeding, in almost one third of the patients who had postoperative blood discharge from the wound. None of the patients needed blood transfusion after the surgical wound bleeding. The bleeding was usually recorded on fourth or fifth day post-surgery. The average age of the patient with postoperative bleeding was 10 years. Apart from the bleeding, infection was recorded as a postoperative complication in 3,5% of the patients that went through surgery. Conclusion: Tonsil surgery is most frequently performed between the age of four and seven. The patients that underwent surgical procedure are mostly male. The most frequent postoperative complications are bleeding and post infection of the postoperative incision, and one third of the patients had both bleeding and infections. Only 0,7 % of the patients needed revision surgery of the surgical wound after bleeding