Curettage adenoidectomy versus endoscopic microdebrider adenoidectomy in children: A randomized controlled trial
Curettage adenoidectomy versus endoscopic microdebrider adenoidectomy in children: A randomized controlled trial
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DOI：
10.1016/j.ijporl.2019.01.018
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发表时间：
2019-04-01
影响因子：
1.5
通讯作者：
Cukurova, Ibrahim
中科院分区：
文献类型：
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作者：
Kozcu, Sureyya Hikmet;Demirhan, Erhan;Cukurova, Ibrahim
腺样体切除术是最常用的外科手术之一，采用不同的技术和技术。虽然刮除腺样体切除术（CA）已经传统地实施了多年，但内镜下微除颤器腺样体切除术（EMA）已经成为一种创新的手术方法。本研究是一项前瞻性、单盲、随机对照试验，目的是比较内镜下微清刷腺样体切除术（EMA）和刮刮腺样体切除术（CA）在儿科人群中的生理效果、疗效和安全性。方法：术前双耳按Jerger分级为a型鼓室图的患儿60例，随机分为CA组（n = 30）和EMA组（n = 30）。术前第一天对每只耳进行鼓室测量，术后第1、7、14天重复。记录术中时间、术中及术后并发症。术后10天的疼痛也被评估。结果：鼓室测量结果显示，术后第1天，EMA组中耳峰值压水平显著低于CA组，术后第7天仅左耳峰值压水平显著低于CA组（P < 0.05）。术后前3天疼痛评分降低与EMA相关，差异有统计学意义（P < 0.05）。两种方法在手术时间和并发症方面无显著差异。结论：根据本研究结果，EMA手术可能与CA手术一样安全、快速。此外，EMA可能更容易控制，对周围组织的侵入性更小。建议进一步的研究来支持这些数据。
Introduction: Adenoidectomy is one of the most frequently performed surgical procedures with different techniques and technologies. Although curettage adenoidectomy (CA) has been practiced conventionally for many years, endoscopic microdebrider adenoidectomy (EMA) has emerged as an innovative surgical method. Comparing physiological effects, efficacy and safety of the endoscopic microdebrider adenoidectomy (EMA) and curettage adenoidectomy (CA) in pediatric population is aimed with this prospective, single-blind, randomized, controlled trial.Methods: Sixty pediatric patients with type-A tympanogram according to Jerger classification in both ears before surgery were randomly assigned to receive the CA (n = 30) and the EMA (n = 30). Tympanometry evaluation for each ear was performed the day before surgery firstly and was repeated on days 1, 7 and 14 after surgery. Intraoperative time, complications during and after the operation were recorded. Postoperative pain was also evaluated for 10 days postoperatively.Results: Tympanometric evaluation revealed significantly reduced middle ear peak pressure levels with the EMA than with the CA for each ear on day 1 after surgery and for only left ear on day 7 after surgery (P < 0.05). In addition, statistically significant reduced pain scores in postoperative first 3 days were related to the EMA (P < 0.05). There was no significant difference between the methods in terms of duration of surgery and complications.Conclusion: According to findings from this study, the EMA procedure may be as safe and rapid as the CA. Furthermore, the EMA may be more controlled and less invasive to the surrounding tissues. Further studies are advised to support these data.