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"The importance of preoperative evaluations prior to pediatric otorhinolaryngological surgery"
Beatriz Pallarés Martí1, Natsuki Oishi1, José Ramón Alba1
1ENT Department, Valencia Medical School, Valencia University General Hospital, Valencia, Spain.
Insights
Preoperative evaluations for pediatric surgery revealed that surgical indications changed in 52% of patients after an average 11-month wait. Reassessment is crucial, especially for children over five, due to the dynamic nature of pediatric conditions.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Clinical Evaluation
Background:
- Pediatric surgical indications can evolve over time, particularly for benign conditions.
- The natural course of diseases in children, influenced by growth and immune development, may alter the need for surgery.
- Preoperative reassessment is essential to ensure appropriate surgical intervention.
Purpose of the Study:
- To evaluate changes in surgical indications for pediatric patients awaiting surgery.
- To determine the frequency and reasons for changes in surgical indications.
- To identify patient groups that may benefit most from preoperative reassessment.
Main Methods:
- A retrospective review of 99 pediatric patients on a surgical waiting list.
- Analysis of changes in surgical indication status before surgery.
- Statistical correlation between patient age and changes in surgical indication.
Main Results:
- Surgical indications changed in 52% of patients after an average wait of 11 months.
- 33% of cases resolved spontaneously, no longer meeting surgical criteria.
- A significant relationship (p=0.034) was found between patient age and changes in surgical indication.
Conclusions:
- Benign pediatric pathologies, such as Waldeyer ring issues, exhibit dynamic changes.
- Preoperative clinical evaluation is recommended for pediatric surgery, particularly for children over 5 years old.
- Dynamic assessment ensures surgical appropriateness and optimizes patient outcomes.
Objective:
To describe the results of preoperative evaluations prior to pediatric surgery.
Materials And Methods:
We reviewed a total of 99 patients, with mean age of 6.53 + 2.39 years, an average of 11.04 months after their inclusion on the surgical treatment list. These patients were obtained from General University Hospital of Valencia surgery waiting list between October 2015 and July 2016. We have reassessed all the patients before their surgery date and analyzed the results: the indication had changed or not. In the case of indication changed, the outcome was subdivided into: extension, reduction, or surgery no indicated because a clinical resolution.
Results:
After waiting on the list for surgery for an average of 11 months, the initial surgical indication had changed in 52 patients (52%), this groups was subdivided into: 33 patients (33%) had spontaneously resolved by the time of their reassessment and their clinical symptoms no longer met the criteria for surgery, the indication for surgery was extended in 10 patients (10%) and was reduced another 9 patients (9%). We found a statistically significantrelationship (p = 0.034) between the age of the patients at the time of the preoperative re- evaluation and modifications made to the initial surgery indication.
Conclusions:
Our results show the dynamic evolution of benign Waldeyer-ring related pathologies in the pediatric population due to physical growth and immune development. The clinical evaluation prior to benign pediatric surgery is recommended In specially in the group over 5 years.
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