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Late posttonsillectomy haemorrhage, differences in unilateral versus bilateral tonsillectomy, a retrospective
Jan Vodicka1,2, Viktor Chrobok2, Martin Chovanec3
1Department of Otorhinolaryngology and Head and Neck Surgery, Hospitals of Pardubice Region-Hospital in Pardubice, Faculty of Health Studies, University of Pardubice, 532 03, Pardubice, Czech Republic.
Scientific Reports
|December 24, 2025
Summary
Late post-tonsillectomy hemorrhage (LPTH) risk is higher in bilateral procedures. Hospital choice, patient age, and gender significantly influence LPTH occurrence, while anticoagulants and antiplatelet drugs affect bleeding severity.
Area of Science:
- Otolaryngology
- Surgical Complications
- Hemorrhagic Events
Background:
- Tonsillectomy (TE) is a common head and neck surgery with potential complications.
- Post-tonsillectomy hemorrhage (PTH) is a significant concern, particularly late post-tonsillectomy hemorrhage (LPTH).
- Understanding factors influencing LPTH is crucial for patient safety and surgical outcomes.
Purpose of the Study:
- To investigate the incidence and influencing factors of late post-tonsillectomy hemorrhage (LPTH).
- To compare LPTH rates between unilateral and bilateral tonsillectomy procedures.
- To identify patient and procedural factors associated with LPTH occurrence and severity.
Main Methods:
- A multicentric retrospective study analyzing data from 8166 patients undergoing tonsillectomy between 2014 and 2018.
- Analysis of 14,030 unilateral tonsillectomies, comparing outcomes of primarily unilateral versus bilateral procedures.
- Statistical analysis to determine the impact of surgery type, patient demographics, medication use, and surgical factors on LPTH.
Main Results:
- Late post-tonsillectomy hemorrhage (LPTH) occurred in 9.12% of unilateral tonsillectomies overall.
- LPTH was significantly more frequent in bilateral procedures (18.11%) compared to unilateral (9.43%).
- Hospital choice, patient age, and gender were significant factors for LPTH occurrence (p < 0.0001).
- Anticoagulant and antiplatelet medication use was associated with increased bleeding (p = 0.0449 and p = 0.0160, respectively) and severity (p = 0.0002 and p = 0.0404, respectively).
- Surgical technique, surgeon experience, and electrocoagulation did not significantly impact LPTH.
Conclusions:
- Methodology is critical when studying LPTH, with significant differences observed between unilateral and bilateral tonsillectomy approaches.
- Patient demographics (age, gender) and hospital choice are key determinants of LPTH occurrence.
- The use of anticoagulants and antiplatelet agents influences the severity of post-tonsillectomy bleeding.
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