The impact of comorbid diseases on postoperative complications in children after adenotonsillectomy: Is it a myth?

Abstract

Objective: Adenotonsillar surgery remains the second most common surgical practice in pediatric otolaryngology. We aimed to evaluate whether a comorbid disease in children undergoing surgery has any impact on postoperative complication rate.

Methods: This study was conducted at a tertiary otolaryngology department with 643 children. The study included children with symptoms of obstructive sleep-disordered breathing and recurrent infection who underwent adenotonsillar surgery. Patients with a comorbid disease constituted the study group and otherwise healthy children constituted the control group. The data were evaluated to find out any association among clinical variables such as gender, age, tonsil grade, type and extent of surgery, indication for surgery, body mass index percentile, comorbid diseases and postoperative complications.

Results: There were 245 (38.1%) patients with a comorbid disease. The most common comorbidity was cardiovascular diseases (n=68) followed by neurological diseases (n=48). We performed adenoidecto-my in 319, tonsillectomy in 44, tonsillotomy in nine, adenotonsillectomy (AT) in 190 and adenoidectomy with tonsillotomy (ATT) in 81 patients. The overall rate of postoperative late complication was 17/643 (2.6%) with post-tonsillectomy hemorrhage being the most common (n=10). There was no association between other clinical variables and the complication but older age (p=0.042) and type of surgery (p<0.001) revealed increased risk. The rates of complications in patients with or without comorbid disease were found 5/245 (2%) and 12/389 (3%), respectively, with no difference (p=0.621).

Conclusion: The risk of postoperative complications was increased in older children and in patients undergoing AT and ATT, however, the presence of comorbid disease did not increase likelihood of postoperative complications.