Factors influencing the frequency of re-adenotomies in childhood

Introduction 

Adenotomy (AT) is one of the most common surgical procedures in childhood with approximately 40,000 ATs annually in Germany. The primary objective of our study was to assess the incidence of multiple re-adenotomies at the University Hospital Freiburg between 2005 and 2020 and to investigate potential influencing factors.

Material and Methods 

This is a retrospective study of the incidence of repeated Re-AT after primary and Re-AT at the University Hospital Freiburg. The following influencing factors were considered: Age at primary intervention, gender, symptomatology, additional interventions (e.g., paracentesis), and secondary diseases (e.g., gastroesophageal reflux, GERD). SVM analysis was used to evaluate the influence of the above factors.

Results 

We were able to include 113 patients with primary surgery and re-AT. Of these, 10 patients had more than one Re-AT – 8.8% of our collective. The following symptoms before primary intervention could be identified as risk factors for repeated re-ATs: (1) ronchopathy, (2) otitis media, and (3) language development delay. Whenever we placed a tympanostomy tube or performed a tonsillotomy during primary AT, repeat procedures were less likely to occur.

Discussion 

Germany shows an incidence rate of 9.1% for re-ATs; similar to the incidence for repeated re-ATs of 8.8% in our collective. Risk factors that we could identify in this evaluation do not coincide with the risk factors for re-AT described in the literature: GERD, age at first procedure, gender. In contrast to the literature, our evaluation showed an advantage for simultaneously performed tympanostomy tube insertions or tonsillotomies.

Publication History

Article published online:
24 May 2022