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

Population-based data on incidence of complications after pediatric adenoidectomy are sparse. Therefore, a retrospective population-based study of all 2105 pediatric adenoidectomies (59.9% male, median age: 4 years) in the year 2019 in all otolaryngology departments in one federal state, Thuringia, in Germany, was performed. Patients' and treatment characteristics, and complications were analyzed. The highest surgery rate was seen at the age of 3 years (2747.4 per 100,000 children). Adenoidectomy was combined with tonsillotomy or tonsillectomy in 29.2% and 1.5% of the cases. Postoperative bleeding needing re-surgery occurred in 1.1% of all cases. The revision surgery for bleeding rate after solitary adenoidectomy was 0.7%. A wound infection was seen in 1.0%. Complications classified according to the Clavien-Dindo classification (CDC) occurred in 2.6% of cases. The overall complication rate was 20.3/100,000 population. Additional tonsillectomy was independently associated to bleeding > 24 h after surgery (Odds ratio [OR] = 52.141; confidence interval [CI] = 7.772-349.818; p < 0.0001). There was no independent associative factor to enhanced risk of wound infection. CDC complications occurred more frequently in comorbid patients (OR = 4.175; CI = 1.222-14.271; p = 0.023), underweight children (OR = 2.430; CI = 1.198-6.571; p = 0.040), when additional tonsillectomy was performed (OR = 11.177; CI = 2.098-59.548; p < 0.0001), and when perioperative antibiotics were applied (OR = 13.251; CI = 5.695-30.834; p < 0.001). Adenoidectomy is very safe surgery. Main risk factor for bleeding complications is additional tonsillectomy, not adenoidectomy itself.