Bacteremia during adenoidectomy: a comparison of suction diathermy adenoid ablation and adenoid curettage.
OBJECTIVE
Transient bacteremia is induced by adenoidectomy when the integrity of the nasopharyngeal membrane is broken. The aim of this study was to determine the incidence of bacteremia in patients undergoing adenoidectomy, to identify the causative organisms, and to compare the incidences of bacteremia between the two techniques suction diathermy and curettage.


METHODS
A prospective single-blind randomized trial was performed. Sixty-four patients between the ages of 2 and 13 years who were undergoing adenoidectomy were included in the study. Exclusion criteria included antimicrobial therapy in the immediate preoperative period and concurrent respiratory tract infection or pyrexia. Patients were randomized in the anesthetic room to either suction diathermy or curettage. Venous blood samples for culture were obtained 30 seconds after the procedure began (intraoperative sample) and 2 minutes after removal of the adenoid tissue (postoperative sample). Postoperative complications were recorded, and all patients were followed in the outpatient department.


RESULTS
Twenty-six patients underwent adenoidectomy by suction diathermy, and 38 underwent adenoidectomy by curettage. In the suction diathermy group, 38.5% of intraoperative and 19.2% of postoperative blood cultures had a positive result for bacteremia. In the curettage group, 31.6% of intraoperative and 23.6% of postoperative blood cultures had a positive result for bacteremia. There was no significant difference between the two groups. The techniques were equivalent in terms of postoperative complications. Gram-positive cocci were the most commonly isolated organisms.


CONCLUSIONS
A transient bacteremia exists after pediatric adenoidectomy, but does not correlate with symptoms or signs. Neither suction diathermy adenoidectomy nor curettage adenoidectomy offers a particular advantage in terms of decreasing the incidence of bacteremia.
Casserly
Paula
P
Department of Otolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin, Republic of Ireland.
Kieran
Stephen
S
Phelan
Eimear
E
Smyth
Edmond
E
Lacy
Peter
P
D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods*; D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003475:Curettage / Q000009:adverse effects*; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000473:pathology / Q000601:surgery; D015994:Incidence; D008297:Male; D015508:Nasal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010033:Otitis Media / Q000150:complications / Q000473:pathology / Q000628:therapy; D011446:Prospective Studies; D016037:Single-Blind Method; D013396:Suction