Factors impacting postoperative haemorrhage after transnasal endoscopic surgery

• Main Authors: Kanako Akita, Masaki Hayama, Takeshi Tsuda, Yohei Maeda, Hitoshi Akazawa, Ayaka Nakatani, Sho Obata, Kazuya Takeda, Hidenori Inohara
• Format: Article
• Language: English
• Published: Stichting NASE 2020-09-01
• Series: Rhinology Online
• Subjects: endoscopic sinus surgery; postoperative haemorrhage; anti-thrombotic medication; sinonasal tumour; low platelet count
• Online Access: https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_88.pdf

Background: Transnasal endoscopic surgery (TES) is an established procedure for the treatment of chronic rhinosinusitis, septal deviation, and paranasal benign tumours. Postoperative haemorrhage (POH) is a common complication following TES. Various studies have addressed the risk factors for intraoperative bleeding and the methods to improve the operative field by reducing bleeding. However, the factors affecting POH following TES have not been fully elucidated. Therefore, we aimed investigate the risk factors for POH following TES. Methodology: We studied 807 patients who underwent TES. The variables between cases with and without POH were compared using univariate and multivariate models. We also examined the site and timing of bleeding. Results: POH was observed in 21 cases (2.6%). Seven cases required treatment in the operation room (0.9%). The most common sites of bleeding were around sphenopalatine foramen, and the median time to POH was the 7th day after surgery. Multivariate analysis showed that anti-thrombotic medication, low platelet count, and surgical indication for sinonasal tumour were independent risk factors for POH. Conclusions: POH after TES is a relatively common complication. Careful intraoperative haemostatic procedures may be required in these cases.