Risk Factors Of Postoperative Hemorrhage After Uvulopharyngopalatoplasty

ObjectiveOur aim was to evaluate the possible risk factors ofpostuvulopalatopharyngoplasty hemorrhage, and hoping to help improvingthe safety of this surgical procedure.Materials and MethodsA retrospective study was undertaken to all the patients who hadunderwent uvulopalatopharyngoplasty during1st, Jan.2009to26th, Oct.2011. And all these patients were operated by the same surgeon. Patientsgeneral information (including age, sex, height, weight and body massindex), disease history (including course of obstructive sleepapnea-hypopnea syndrome, diabetes mellitus, hypertension, alcohol andtobacco using), tests (including polysomnogram, blood routine test,coagulation function and liver function), surgical procedures (includinguvulopalatopharyngoplasty alone, and with unilateral tonsillectomy orbilateral tonsillectomy, and whether there was a foregoing tracheotomy before the main surgery) and information of postoperative bleeding(classification, location and severity) were collected from the case records.In according to whether there was a postuvulopalatopharyngoplastybleeding, all the included patients were divided into two groups as bleedinggroup and non-bleeding group. Statistical analysis was then finished bySPSS19.0.ResultsThe final sample size comprised of164cases, including16inbleeding group, and the rest148cases in the non-bleeding group. The rateof postuvulopalatopharyngoplasty bleeding in this study was9.76%.Patients’ age ranged from18to67years.139of them were male.7(43.75%) patients were primary postoperative hemorrhage, and the rest9(56.25%) were secondary postoperative bleeding.5of postoperativebleeding was located in the capsule of tonsil as the most frequently site,followed by diffusivity and the lower pole of tonsil, each one had4cases.2bleeding were located in the free wall of soft palate. Only one case wasbleeding in the root of the uvula. When the postoperative hemorrhage wasclassified into5degrees, there were2,6,6,2and0cases in each levelranged from I to IV.10(6.10%) patients had underwent foregoingtracheotomy before the main surgery.72cases underwentuvulopalatopharyngoplasty alone, and in the rest,4combined withunilateral tonsillectomy and88with bilateral tonsillectomy. Apnea hypopnea index was ranged from6.5to105.6.17,35and112cases weresuffered from mild, moderate and severe OSAHS separately. There were3diabetes mellitus patients had postoperative bleeding, as a percentage of18.75%in the bleeding group. And the rest7diabetes mellitus patientswere in the non-bleeding group. There was a statistical significance(P=0.026， OR=4.648) between the distributions of diabetes mellitus oftwo groups.62.50%of the bleeding group had hypertension, and there wasonly31.08%non-bleeding patients suffer from this disease (P=0.012，OR=3.696).81.25%postoperative bleeding patients had a history oftobacco using while there was only51.35%smoking patients in thenon-bleeding group (P=0.023， OR=4.105). And nevertheless, lymphocytecount in the bleeding group (2.38±0.65×109/L) was higher than thenon-bleeding group (1.97±0.59×109/L)(P=0.012). However, other factorsshow no statistical significance between these two groups.ConclusionHistory of diabetes mellitus, hypertension, tobacco using and highvessel blood lymphocyte count were related with postoperative bleedingafter uvolopalatopharyngoplasty. Nevertheless, further research is needed.