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ORIGINAL RESEARCH

A Meta-analysis Study on Possible Risk Factors for Primary and Secondary Hemorrhage After Tonsillectomy
Tonsillektomi Sonrası Gelişen Primer ve Sekonder Kanamalarda Olası Risk Faktörleri Üzerine Bir Metaanaliz Çalışması
Received Date : 14 Feb 2021
Accepted Date : 26 May 2021
Available Online : 31 May 2021
Doi: 10.24179/kbbbbc.2021-82301 - Makale Dili: EN
KBB ve BBC Dergisi. 2021;29(3):176-84
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Tonsillectomy is one of the most common surgical operation performed by otorhinolaryngologists, with significantly reduced morbidity and mortality rates due to the operation in parallel with the advances in surgical technique and anesthesia. Posttonsillectomy hemorrhage (PTH) is one of the most common, most reported, and serious complication of tonsillectomy operations. In this context, the aim of this research is to synthesize and reveal a wide-ranging study through meta-analysis of studies examining the risk factors that may cause primary and secondary hemorrhage in patients who have undergone tonsillectomy surgery using data from relatively small samples. Material and Methods: In this study, a meta-analysis of a total of 12 studies on PTH risk factors was conducted. In this meta-analysis, the "effect size" criterion was used, which indicates how much a new method makes a difference compared to the old one. Results: As a result of the study, like the literature, the risk of PTH was found to be higher in men than in women in adults, in children under the age of 15, the difference between boys and girls was quite low. It is considered that fewer studies, especially for children under the age of 15, may influence this. In addition, studies have shown that secondary hemorrhage occurs. Conclusion: As a result of the study, it was determined that women experience PTH more frequently than men, and secondary PTH risk is higher than primary PTH.
ÖZET
Amaç: Tonsillektomi, cerrahi teknik ve anestezideki gelişmelere paralel olarak operasyona bağlı morbidite ve mortalite oranlarının önemli ölçüde azaldığı, kulak-burun-boğaz uzmanları tarafından en sık uygulanan cerrahi operasyonlardan biridir. Tonsillektomi sonrası kanama [post-tonsillectomy hemorrhage (PTH)], tonsillektomi ameliyatlarının en yaygın, en çok bildirilen ve ciddi komplikasyonlarından biridir. Bu bağlamda, bu araştırmanın amacı, tonsillektomi ameliyatı geçiren hastalarda birincil ve ikincil kanamaya neden olabilecek risk faktörlerini nispeten küçük örneklemlerden elde edilen verilerle inceleyen çalışmaların metaanalizi ile geniş kapsamlı bir çalışmayı sentezlemek ve ortaya çıkarmaktır. Gereç ve Yöntemler: Bu çalışmada, PTH risk faktörleri ile ilgili toplam 12 çalışmanın metaanalizi yapılmıştır. Bu metaanalizde, yeni bir yöntemin eskisine göre ne kadar fark yarattığını gösteren “etki büyüklüğü” kriteri kullanılmıştır. Bulgular: Çalışma sonucunda, literatürde olduğu gibi erkeklerde PTH riski erişkinlerde kadınlara göre daha yüksek, 15 yaş altı çocuklarda kız ve erkek çocuklar arasındaki fark oldukça düşük bulunmuştur. Özellikle 15 yaş altı çocuklar için daha az sayıda çalışmanın bunu etkileyebileceği düşünülmektedir. Ek olarak, çalışmalar ikincil kanamanın meydana geldiğini göstermiştir. Sonuç: Çalışma sonucunda, kadınların erkeklerden daha sık PTH yaşadığı ve ikincil PTH riskinin birincil PTH’den daha yüksek olduğu belirlendi.
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