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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
A systematic review of adenotonsillectomy as a risk factor for childhood obesity
Anita Jeyakumar1, Nicholas Fettman, Eric S Armbrecht
1Department of Otolaryngology, Saint Louis University, St Louis, Missouri 63104, USA. ajeyakum@slu.edu
Insights
Tonsillectomy with or without adenoidectomy (T&A) in children is linked to significant postoperative weight gain, particularly in normal and overweight populations. Further research with consistent metrics is needed to confirm this association and its implications for pediatric obesity.
Area of Science:
- Pediatric Surgery
- Obesity Research
- Otolaryngology
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Existing evidence suggests a link between tonsillectomy and increased weight in children, potentially contributing to pediatric obesity.
Purpose of the Study:
- To systematically review the existing literature on whether tonsillectomy, with or without adenoidectomy, is a risk factor for future obesity in children.
Main Methods:
- A systematic literature search was conducted using PubMed and Ovid.
- Analysis included nine studies published between 1970 and 2009, involving 795 children who underwent adenotonsillectomy (T&A) with pre- and postoperative weight measurements.
Main Results:
- Across studies, postoperative weight gain was observed in 46% to 100% of children, with body mass index (BMI) increasing by 5.5% to 8.2% in some groups.
- Normal and overweight children showed a greater than expected weight increase postoperatively.
- Morbidly obese patients did not experience significant weight changes.
Conclusions:
- The reviewed studies indicate a potential association between T&A and increased postoperative weight gain in pediatric populations.
- Limitations include varying definitions of overweight and follow-up periods across studies, and limited demographic data.
- A large-scale study with standardized outcome measures is necessary to solidify these findings.
Objective:
Tonsillectomy is the most common major surgical procedure performed in children. There is evidence that tonsillectomy is associated with weight increase and may contribute to pediatric obesity. The study aimed to review the evidence that tonsillectomy with or without adenoidectomy is a risk factor for future obesity.
Data Sources:
Systematic literature search was performed using PubMed and Ovid.
Review Methods:
Systematic analysis of the literature from 1970 to 2009 on patients who underwent adenotonsillectomy (T&A) with preoperative and postoperative weight-based measurements.
Results:
Nine studies satisfied inclusion criteria. A total of 795 children were included. Preoperative weight ranged from normal to morbid obesity. In total, 656 children had demographic information recorded, and 53.35% of the children were male. Indication for surgery was not recorded in 336 patients. In 47.7% patients, the indication recorded was sleep-disordered breathing. The first group included 3 studies involving 127 children, and body mass index (BMI) increased by 5.5% to 8.2%. The second group included 3 studies involving 419 patients; the standardized weight scores increased in 46% to 100% of patients. The third group included 3 studies with 249 patients; the corrected weight increased postoperatively in 50% to 75% of patients. Morbidly obese patients (weight 130%-260% vs peers) remained unchanged postoperatively.
Limitations:
Each study was designed with different definitions of overweight and a range of follow-up periods. Demographic information was limited.
Conclusions:
A large population of normal and overweight children undergoing T&A gained a greater than expected amount of weight postoperatively, which suggests an association between T&A and weight gain. A significant need exists for a large study with consistent outcomes measured.
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