Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Public Health

Background:

• Population-based data on pediatric adenoidectomy complications are limited.
• Adenoidectomy is a common procedure in children, with the highest incidence in 3-year-olds.
• Understanding complication rates is crucial for patient safety and informed consent.

Purpose of the Study:

• To determine the incidence of complications following pediatric adenoidectomy.
• To identify risk factors associated with complications after adenoidectomy.
• To evaluate the safety of adenoidectomy as a standalone procedure versus combined with tonsillectomy.

Main Methods:

• Retrospective population-based study of 2105 pediatric adenoidectomies in Thuringia, Germany, in 2019.
• Analysis of patient demographics, surgical characteristics, and postoperative complications.
• Utilized Clavien-Dindo classification (CDC) for complication assessment and logistic regression for risk factor analysis.

Main Results:

• Overall complication rate was 2.6% (CDC), with bleeding requiring re-surgery in 1.1% of cases (0.7% for solitary adenoidectomy).
• Wound infection occurred in 1.0% of cases.
• Additional tonsillectomy significantly increased the risk of bleeding (OR=52.141) and CDC complications (OR=11.177).
• Comorbidities, underweight status, and perioperative antibiotics were associated with higher CDC complication rates.

Conclusions:

• Pediatric adenoidectomy is a very safe surgical procedure.
• Additional tonsillectomy is the main risk factor for postoperative bleeding, not adenoidectomy alone.
• Identifying high-risk patients (comorbid, underweight) and judicious use of antibiotics can further improve safety outcomes.