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Tonsillectomy and adenotonsillectomy in Sudanese patients
1Department of Surgery, Faculty of Medicine, University of Khartoum.
Objectives:
To highlight the indications for and complications of tonsillectomy or adenotonsillectomy operations in Sudanese patients and to find out whether any correlation can be deduced between routinely requested pre-operative investigations and the complications which may arise.
Design:
A prospective study.
Setting:
Khartoum ENT Teaching Hospital, Khartoum, Sudan.
Subjects:
One hundred and twenty patients, 55% females and 45% males, age range 3 to 50 years. Pre-operative investigations consisted of a complete blood count and bleeding and clotting times., ASO titres and urinalysis.
Interventions:
Consisted of tonsillectomy or adenotonsillectomy performed on in-patients by one of the authors under general anaesthesia.
Main Outcome Measures:
High erythrocyte sedimentation rate (ESR) or ASO titres should not deter an indicated tonsillectomy operation which can still be carried out if meticulous haemostasis is observed.
Results:
Three or more episodes of exudative tonsillitis per year and upper airway obstruction were the commonest indications for tonsillectomy or adenotonsillectomy accounting for 72.5% and 16.7% of the operations. Intra-operative bleeding occurred in 63 (52.5%) of the patients. Low figures of reactionary and secondary haemorrhages were seen.
Conclusion:
It is concluded that as bleeding, both intra- and post-operative is the main complication of tonsillectomy, its incidence can be reduced to minimal levels by careful selection of patients, in whom the operation is carried out under general anaesthesia with gentle handling of tissues and detention of the patients post-operatively for two to three days. We also found out that coagulation tests need not be routinely requested and reserved for patients with a history of bleeding tendencies.