[Analysis and management of postoperative hemorrhage in surgery of obstructive sleep apnea hypopnea syndrome in children using plasma-mediated radio-frequency ablation at low temperature].
OBJECTIVE
To analyze retrospectively cause, prevention and management of postoperative hemorrhage in surgery of obstructive sleep apnea hypopnea syndrome (OSAHS) in children using plasma-mediated radio-frequency (pmRF) ablation at low temperature.


METHODS
Tonsil and adenoid ablation were carried out in 4028 cases diagnosed with OSAHS, using ENTColator lI plasma system of Arthocare company under general anesthesia.


RESULTS
Postoperative hemorrhage occurred in 37 cases of 4028 cases, among which 1 case occurred after tonsil ablation and other 36 cases occurred after adenoid ablation. Primary hemorrhage was in 7 cases, while secondary hemorrhage in other 30 cases. Cessation of bleeding was achieved by using different methods of hemostasis in all cases.


CONCLUSIONS
Tonsil and adenoid ablation were performed by pmRF at low temperature with advantages of less trauma, less bleeding. However, postoperative hemorrhage might occur in a few cases (accounting for 0.92%). Postoperative hemorrhage in these patients was related with preoperatively incomplete control of inflammation of tonsil or adenoid, surgeon's experience, intraoperatively incomplete hemostasis, postoperative crying and restlessness, eating improperly in two weeks after surgery, coagulation factor deficiency. In case of postoperative hemorrhage, good outcome could be achieved by management of compression, pmRF at low temperature, bipolar coagulation.
Department of Otolaryngology, Haimen People's Hospital, Haimen, 226100, China.
Jun
J
Wang
Department of Otolaryngology, Children's Medical Center, Shanghai Jiaotong University School of Medicine.
Jie
J
Chen
Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Ear Institute, Shanghai Jiaotong University School of Medicine.
Jun
J
Yang
D000293:Adolescent; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature; D006801:Humans; D007223:Infant; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*