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  • Title: Post-tonsillectomy hemorrhage in children with hematological abnormalities.
    Author: Venkatesan NN, Rodman RE, Mukerji SS.
    Journal: Int J Pediatr Otorhinolaryngol; 2013 Jun; 77(6):959-63. PubMed ID: 23582539.
    Abstract:
    OBJECTIVE: Tonsillectomy is a common procedure performed in children with the main complication being post-operative hemorrhage. It is uncertain if patients with hematological abnormalities face a higher risk of post-operative hemorrhage. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral hospital. PATIENTS SELECTED: All patients with a known hematologic disorder as well as children without a hematologic abnormality undergoing tonsillectomy with or without adenoidectomy in the past two years at our institution were included in this study. MAIN OUTCOME MEASURE: We sought to determine whether children with hematologic disorders are at an increased risk of post-operative hemorrhage after surgery. RESULTS: Four-hundred and sixty-two patients were identified who underwent a tonsillectomy during this time period. Fourteen patients with hematological abnormalities were identified with only one patient suffering a post-tonsillectomy hemorrhage. All patients with abnormal laboratory values prior surgery underwent medical treatment in conjunction with pediatric hematology and did not suffer a post-tonsillectomy hemorrhage. Despite a small study group, the low incidence (1/14) of post-tonsillectomy hemorrhage in patients with hematological abnormalities suggests that these patients may not be at an increased risk, especially if appropriately evaluated and treated pre-operatively. CONCLUSION: Despite small sample size the results of our study suggest that patients with coagulation disorders may not have an increased risk of post-tonsillectomy hemorrhage when evaluated and corrected pre-operatively.
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