Hemorragia pós-amigdalectomia em crianças com distúrbios de coagulação

Objectives: Tonsillectomy is amongst the most common surgical procedures performed in children with the main complication being post-operative hemorrhage. The objective of this study is to report the tonsillectomy outcomes of children with altered coagulation parameters managed at our institution. Study Design: Retrospective study with descriptive analysis of data collected. Material and Methods: We reviewed all patients undergoing tonsillectomy with or without adenoidectomy between January 1st 2012 and December 31st 2016 at Hospital Pediatrico de Coimbra and selected patients with altered coagulation parameters. Results: Fifty-five patients with hematological abnormalities were identified, with this patients having a mean age of 6.2±3.2 years old and female patients representing the majority of cases (52,7%). Only five children (9,1%) had a previously known hematologic disorder with others being diagnosed preoperatively with a first screen composed by Prothrombin Time (13,5sec±2.1) and Activated Partial Thromboplastin Time (38,9±4,0). A posterior hematologic evaluation with laboratory tests identified factor VII (21 cases, 38,1%) as the most common deficiency. Only thirteen (23,6%) received perioperative hematologic medications and eight (14,5%) remained at hospital during the first week after surgery for close surveillance. There were no patients suffering post-tonsillectomy hemorrhage. Conclusion: Our results are in line with the studies published in literature reporting tonsillectomy as being a secure procedure with low rates of post-operative hemorrhage in these children.