Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study

Abstract Population-based data on incidence of complications after pediatric adenoidectomy are sparse. Therefore, a retrospective population-based study of all 2105 pediatric adenoidectomies (59.9% male, median age: 4 years) in the year 2019 in all otolaryngology departments in one federal state, Th...

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Main Authors: Hannah Losgar, Daniel Boeger, Jens Buentzel, Kerstin Hoffmann, Jiri Podzimek, Holger Kaftan, Andreas Mueller, Sylvia Tresselt, Katharina Geißler, Orlando Guntinas-Lichius
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13803-9
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author Hannah Losgar
Daniel Boeger
Jens Buentzel
Kerstin Hoffmann
Jiri Podzimek
Holger Kaftan
Andreas Mueller
Sylvia Tresselt
Katharina Geißler
Orlando Guntinas-Lichius
author_facet Hannah Losgar
Daniel Boeger
Jens Buentzel
Kerstin Hoffmann
Jiri Podzimek
Holger Kaftan
Andreas Mueller
Sylvia Tresselt
Katharina Geißler
Orlando Guntinas-Lichius
author_sort Hannah Losgar
collection DOAJ
description Abstract Population-based data on incidence of complications after pediatric adenoidectomy are sparse. Therefore, a retrospective population-based study of all 2105 pediatric adenoidectomies (59.9% male, median age: 4 years) in the year 2019 in all otolaryngology departments in one federal state, Thuringia, in Germany, was performed. Patients’ and treatment characteristics, and complications were analyzed. The highest surgery rate was seen at the age of 3 years (2747.4 per 100,000 children). Adenoidectomy was combined with tonsillotomy or tonsillectomy in 29.2% and 1.5% of the cases. Postoperative bleeding needing re-surgery occurred in 1.1% of all cases. The revision surgery for bleeding rate after solitary adenoidectomy was 0.7%. A wound infection was seen in 1.0%. Complications classified according to the Clavien-Dindo classification (CDC) occurred in 2.6% of cases. The overall complication rate was 20.3/100,000 population. Additional tonsillectomy was independently associated to bleeding > 24 h after surgery (Odds ratio [OR] = 52.141; confidence interval [CI] = 7.772-349.818; p < 0.0001). There was no independent associative factor to enhanced risk of wound infection. CDC complications occurred more frequently in comorbid patients (OR = 4.175; CI = 1.222–14.271; p = 0.023), underweight children (OR = 2.430; CI = 1.198–6.571; p = 0.040), when additional tonsillectomy was performed (OR = 11.177; CI = 2.098–59.548; p < 0.0001), and when perioperative antibiotics were applied (OR = 13.251; CI = 5.695–30.834; p < 0.001). Adenoidectomy is very safe surgery. Main risk factor for bleeding complications is additional tonsillectomy, not adenoidectomy itself.
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spelling doaj-art-770d012942ca481f86c4e4cb9ed719dd2025-08-20T04:03:06ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-13803-9Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based studyHannah Losgar0Daniel Boeger1Jens Buentzel2Kerstin Hoffmann3Jiri Podzimek4Holger Kaftan5Andreas Mueller6Sylvia Tresselt7Katharina Geißler8Orlando Guntinas-Lichius9Department of Otorhinolaryngology, Jena University HospitalDepartment of OtorhinolaryngologyDepartment of OtorhinolaryngologyDepartment of Otorhinolaryngology, Sophien/Hufeland-KlinikumDepartment of Otorhinolaryngology, Klinikum Bad SalzungenDepartment of Otorhinolaryngology, Helios-KlinikumDepartment of Otorhinolaryngology, SRH Wald-KlinikumDepartment of Otorhinolaryngology, Ilm-Kreis-KlinikenDepartment of Otorhinolaryngology, Jena University HospitalDepartment of Otorhinolaryngology, Jena University HospitalAbstract Population-based data on incidence of complications after pediatric adenoidectomy are sparse. Therefore, a retrospective population-based study of all 2105 pediatric adenoidectomies (59.9% male, median age: 4 years) in the year 2019 in all otolaryngology departments in one federal state, Thuringia, in Germany, was performed. Patients’ and treatment characteristics, and complications were analyzed. The highest surgery rate was seen at the age of 3 years (2747.4 per 100,000 children). Adenoidectomy was combined with tonsillotomy or tonsillectomy in 29.2% and 1.5% of the cases. Postoperative bleeding needing re-surgery occurred in 1.1% of all cases. The revision surgery for bleeding rate after solitary adenoidectomy was 0.7%. A wound infection was seen in 1.0%. Complications classified according to the Clavien-Dindo classification (CDC) occurred in 2.6% of cases. The overall complication rate was 20.3/100,000 population. Additional tonsillectomy was independently associated to bleeding > 24 h after surgery (Odds ratio [OR] = 52.141; confidence interval [CI] = 7.772-349.818; p < 0.0001). There was no independent associative factor to enhanced risk of wound infection. CDC complications occurred more frequently in comorbid patients (OR = 4.175; CI = 1.222–14.271; p = 0.023), underweight children (OR = 2.430; CI = 1.198–6.571; p = 0.040), when additional tonsillectomy was performed (OR = 11.177; CI = 2.098–59.548; p < 0.0001), and when perioperative antibiotics were applied (OR = 13.251; CI = 5.695–30.834; p < 0.001). Adenoidectomy is very safe surgery. Main risk factor for bleeding complications is additional tonsillectomy, not adenoidectomy itself.https://doi.org/10.1038/s41598-025-13803-9AdenoidectomyTonsillectomyTonsillotomyComplicationsClavien-Dindo classificationIncidence rate
spellingShingle Hannah Losgar
Daniel Boeger
Jens Buentzel
Kerstin Hoffmann
Jiri Podzimek
Holger Kaftan
Andreas Mueller
Sylvia Tresselt
Katharina Geißler
Orlando Guntinas-Lichius
Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
Scientific Reports
Adenoidectomy
Tonsillectomy
Tonsillotomy
Complications
Clavien-Dindo classification
Incidence rate
title Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
title_full Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
title_fullStr Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
title_full_unstemmed Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
title_short Pediatric adenoidectomy is safe surgery with a low complication rate: a population-based study
title_sort pediatric adenoidectomy is safe surgery with a low complication rate a population based study
topic Adenoidectomy
Tonsillectomy
Tonsillotomy
Complications
Clavien-Dindo classification
Incidence rate
url https://doi.org/10.1038/s41598-025-13803-9
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