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A Cost-effective Approach for Preoperative Hemostatic Assessment in Children Undergoing Adenotonsillectomy
Arch Otolaryngol Head Neck Surg. 2000;126:688.
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Tonsillectomy with or without adenoidectomy is the most common major surgical procedure performed in pediatric patients1 and is often their first hemostatic challenge. Of the potential complications that may occur, excessive perioperative and postoperative bleeding are among those that cause the most angst. Although there is no foolproof, inexpensive method of preoperative detection of all patients with coagulation disorders, routine screening using PT, PTT, and BT are advocated by many practitioners. In 1995, the American Academy of Otolaryngology–Head and Neck Surgery made the recommendation that coagulation studies be used in selective patients with suggestive histories or if genetic information is unavailable.2 I strongly support this recommendation.
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As referenced by Hartnick and Ruben, we have published the largest series to date showing the efficacy of selective screening.3 In our 6-year retrospective review, we used a 6-question questionnaire (Table 1) to compare 1750 children who were . . . [Full Text of this Article]
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