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Fetyukov A.V.

Pavlov Ryazan State Medical University;
Semashko Regional Clinical Hospital

Pshennikov D.S.

Pavlov Ryazan State Medical University;
Semashko Regional Clinical Hospital

Risk factors for postoperative bleeding after tonsillectomy. Systematic review

Authors:

Fetyukov A.V., Pshennikov D.S.

More about the authors

Journal: Russian Bulletin of Otorhinolaryngology. 2025;90(5): 94‑99

DOI: 10.17116/otorino20259005194

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Table of contents

RISK FACTORS FOR POSTOPERATIVE BLEEDING AFTER TONSILLECTOMY. SYSTEMATIC REVIEW
RISK FACTORS FOR POSTOPERATIVE BLEEDING AFTER TONSILLECTOMY. SYSTEMATIC REVIEW

To cite this article:

Fetyukov AV, Pshennikov DS. Risk factors for postoperative bleeding after tonsillectomy. Systematic review. Russian Bulletin of Otorhinolaryngology. 2025;90(5):94‑99. (In Russ.)
https://doi.org/10.17116/otorino20259005194

Подписка 2026 Вестник оториноларингологии (Russian Bulletin of Otorhinolaryngology)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

Surgical intervention remains one of the main methods of treating chronic tonsillitis, it allows patients to completely eliminate the symptoms of the disease and improve their quality of life. However, bilateral tonsillectomy is associated with the risk of postoperative complications, which are often life-threatening for the patient. The presented systematic review contains information about bleeding that occurs after bilateral tonsillectomy, as well as measures to prevent it. The analysis includes original articles, case reports, and literature reviews.

Keywords:

chronic tonsillitis
tonsillectomy
complications
bleeding
prevention

Authors:

Fetyukov A.V.

Pavlov Ryazan State Medical University;
Semashko Regional Clinical Hospital

Pshennikov D.S.

Pavlov Ryazan State Medical University;
Semashko Regional Clinical Hospital

Received:

04.03.2025

Accepted:

20.05.2025

Close metadata

References:

  1. Artyushkin SA, Yunusov AS, Ryazantsev SV, Eremina N V, Gurov A V, Karneeva O V, Svistushkin VM, Il’enko LI, Zavalii MA, Polunin MM, Shakhov AV, Dzhamaludinov YuA, Yakovlev SV. Khronicheskij tonzillit. Klinicheskie rekomendatsii. Natsional’naya meditsinskaya assotsiatsiya otorinolaringologov. M. 2024. (In Russ.). Accessed August 18, 2025. https://cr.minzdrav.gov.ru/view-cr/683_2
  2. Shishkunova TM. Modern methods of diagnosis and conservative treatment of chronic tonsillitis. Russian Otorhinolaryngology. 2022;3(118):96-111. (In Russ.). https://doi.org/10.18692/1810-4800-2022-3-96-111
  3. Krukov AI, Aksenova AV, Zakharova AF, Chumakov PL, Zhuk LG. Peculiarities of epidemiology of chronic tonsillitis under current conditions of providing specialized aid to the patients presenting with ENT diseases. Russian Bulletin of Otorhinolaryngology. 2013;78(3):4-7. (In Russ.).
  4. Murashko AO, Smolina OO, Dolgikh SS. Complex approach to prevention of acute tonsillitis in educational institutions. Nauka molodykh. Eruditio Juvenium. 2019;7(2):211-222.  https://doi:10.23888/HMJ201972211-222
  5. Krukov AI, Tsarapkin GYu, Ivoĭlov AIu, Tovmasyan AS, Artemyeva-Karelova AV, Kirasirova EA, Polyayeva MYu.Surgical interventions on the pharynx in the structure of otorhinolaryngological care to the population of the city of Moscow. Russian Bulletin of Otorhinolaryngology. 2019;84(5):32-37. (In Russ.). https://doi.org/10.17116/otorino20198405132
  6. Tovmasyan AS, Golubeva LI, Zotova PK, Muratov DL, Shvedov NV, Golovatyuk AA, Filina EV, Kryukova MS, Ramazanov SR. The role of tonsillectomy in the treatment of chronic tonsillitis. Russian Bulletin of Otorhinolaryngology. 2023;88(2):67-73. (In Russ.). https://doi.org/10.17116/otorino20228802167
  7. Lopatin AS, Chuchueva ND. Hemorrhage following tonsillectomy: analysis of the prevalence and risk factors. Russian Bulletin of Otorhinolaryngology. 2013;78(3):71-75. (In Russ.).
  8. Slouka D, Čejková Š, Hanáková J, Hrabačka P, Kormunda S, Kalfeřt D, Skálová A, Šimánek V, Kucera R. Risk of Postoperative Bleeding in Tonsillectomy for Peritonsillar Abscess, as Opposed to in Recurrent and Chronic Tonsillitis — A Retrospective Study. International Journal of Environmental Research and Public Health. 2021;18(4):1946. https://doi.org/10.3390/ijerph18041946
  9. Allareddy V, Martinez-Schlurmann N, Rampa S, Nalliah RP, Lidsky KB, Allareddy V, Rotta AT. Predictors of Complications of Tonsillectomy With or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study. Clinical Pediatrics. 2016;55(7):593-602.  https://doi.org/10.1177/0009922815616885
  10. Kozy`reva EE. Tonzillektomiya s ispol’zovaniem poluprovodnikovogo lazera s dlinoj volny 970 nm: tekhnika, preimushchestva: Avtoref. diss. ... kand. med. nauk. SPb; 2019. (In Russ.).
  11. Kim MK, Lee JW, Kim MG, Ha SY, Lee JS, Yeo SG. Analysis of prognostic factors for postoperative bleeding after tonsillectomy. European Archives of Oto-Rhino-Laryngology. 2012;269(3):977-981.  https://doi.org/10.1007/s00405-011-1697-5
  12. Handler SD, Miller L, Richmond KH, Baranak CC. Post-tonsillectomy hemorrhage: incidence, prevention and management. Laryngoscope. 1986;96(11):1243-1247. https://doi.org/10.1002/lary.1986.96.11.1243
  13. Mohammadpour-Maleki A, Rasoulian B. Post-tonsillectomy Hemorrhage: A Seven-year Retrospective Study. Iranian Journal of Otorhinolaryngology. 2021;33(118):311-318.  https://doi.org/10.22038/ijorl.2021.54962.2882
  14. Pace A, Iannella G, Magliulo G. Barbed tonsillectomy. European Archives of Oto-Rhino-Laryngology. 2025;282(3):1649-1652. https://doi.org/10.1007/s00405-024-08953-x
  15. Budko EV, Chernikova DA, Yampol`skij LM, Yaczyuk VYa. Local hemostatic agents and ways to improve them. Rossijskij mediko-biologicheskij vestnik im. akademika IP. Pavlova. 2019;27(2):274-285. (In Russ.). https://doi.org/10.23888/PAVLOVJ2019272274-285
  16. Windfuhr JP, Chen YS. Post-tonsillectomy and -adenoidectomy hemorrhage in nonselected patients. The Annals of Otology, Rhinology, and Laryngology. 2003;112(1):63-70.  https://doi.org/10.1177/000348940311200113
  17. Alsalamah S, Alsumairi S, Alaraifi A, Alfayez A, Halawani M. Incidence and predictive factors of bleeding following tonsillectomy among pediatrics: A retrospective cohort study. Saudi Medical Journal. 2024;45(7):694-699.  https://doi.org/10.15537/smj.2024.45.7.2024025
  18. Asulin Z, Cohen O, Forer B, Sichel JY, Attal P, Shaul C. Comparison of postoperative bleeding in pediatric tonsillectomy versus tonsillotomy. International Journal of Pediatric Otorhinolaryngology. 2024; 186:112125. https://doi.org/10.1016/j.ijporl.2024.112125
  19. Aldrees T, Alzuwayed A, Majed A, Alzamil A, Almutairi M, Aloqaili Y. Evaluation of Secondary Post-Tonsillectomy Bleeding among Children in Saudi Arabia: Risk Factor Analysis. Ear, Nose and Throat Journal. 2022;101(3):NP135-NP142. https://doi.org/10.1177/0145561320944662
  20. Ryabova MA, Kolesnikova OM, Posobilo EE, Potapova PD. Bleeding in the early period after tonsillectomy: analysis of the main causes and predisposing factors. Prakticheskaya meditsina. 2016;3(95):95-98. (In Russ.).
  21. Johnson RF, Beams DR, Zaniletti I, Chorney SR, Kou YF, Lenes-Voit F, Ulualp S, Liu C, Mitchell RB. Estimated Probability Distribution of Bleeding After Pediatric Tonsillectomy: A Retrospective National Cohort Study of US Children. JAMA Otolaryngology — Head and Neck Surgery. 2023;149(5):431-438.  https://doi.org/10.1001/jamaoto.2023.0268
  22. Patel SD, Daher GS, Engle L, Zhu J, Slonimsky G. Adult tonsillectomy: An evaluation of indications and complications. American Journal of Otolaryngology. 2022;43(3):103403. https://doi.org/10.1016/j.amjoto.2022.103403
  23. Kairov GT, Klimenkova VF, Tyutrin II, Udut VV. Hemostatic potential of whole blood in the dynamics of a normal menstrual cycle in healthy women. Byulleten’ meditsinskikh internet-konferentsij. 2016;8:1418-1419. (In Russ.).
  24. Koh SC, Prasad RN, Fong YF. Hemostatic status and fibrinolytic response potential at different phases of the menstrual cycle. Clinical and Applied Thrombosis/Hemostasis. 2005;11(3):295-301.  https://doi.org/10.1177/107602960501100308
  25. Dhaduk N, Rodgers A, Govindan A, Kalyoussef E. Post-Tonsillectomy Bleeding: A National Perspective. The Annals of Otology, Rhinology, and Laryngology. 202;130(8):941-947.  https://doi.org/10.1177/0003489420987438
  26. Ketterer MC, Maier M, Burkhardt V, Mansour N, Knopf A, Becker C. The peritonsillar abscess and its management — is incision and drainage only a makeshift to the tonsillectomy or a permanent solution? Frontiers in Medicine. 2023;10:1282040. https://doi.org/10.3389/fmed.2023.1282040
  27. Masalha M, DeRowe A, Landsberg R, Mazzawi S, Shlizerman L, Kassem F, Fadel A. Is Postextracapsular Tonsillectomy Bleeding More Common on the Side of the Surgeon’s Nondominant Hand? Otolaryngology — Head and Neck Surgery. 2021;165(3):419-423.  https://doi.org/10.1177/0194599820982636
  28. Hinton-Bayre AD, Noonan K, Ling S, Vijayasekaran S. Experience is more important than technology in paediatric post-tonsillectomy bleeding. The Journal of Laryngology and Otology. 2017;131(S2):S35-S40.  https://doi.org/10.1017/S0022215117000755
  29. Blanchford H, Lowe D. Cold versus hot tonsillectomy: state of the art and recommendations. Orl-Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2013;75(3):136-1341. https://doi.org/10.1159/000342315
  30. Semenov FV, Gorbonosov IV, Vartanyan MS, Merzhoev TM, Drobzhev SA. Comparison of tonsillectomy methods using bipolar cauterization and cold dissection. Prakticheskaya meditsina. 2011;51:26-28. (In Russ.).
  31. Panasov AS. Optimizatsiya khirurgicheskogo lecheniya patsientov s khronicheskim tonzillitom: Avtoref. diss.... kand. med. nauk. M. 2021. (In Russ.).
  32. Ghiyali VS, Minhas RS, Azad RK, Thakur JS. Is Laser Better than Cold Steel (Dissection and Snare) for Tonsillectomy? Indian Journal of Otolaryngology and Head and Neck Surgery. 2023;75(2):343-346.  https://doi.org/10.1007/s12070-022-03182-2
  33. Bhankhodia BP, Aiyer RG, Raval JB. Comparative Study of CO2 LASER Assisted and Electrocautery Assisted Tonsillectomy with Conventional Tonsillectomy. Indian Journal of Otolaryngology and Head and Neck Surgery. 2022;74(Suppl 3):5324-5328. https://doi.org/10.1007/s12070-021-02381-7
  34. Tsikopoulos A, Fountarlis A, Tsikopoulos K, Dilmperis F, Tsikopoulos I, Garefis K, Karkos P, Skoulakis C, Triaridis S. CO2 laser or dissection tonsillectomy: A systematic review and meta-analysis of clinical outcomes. Auris, Nasus, Larynx. 2023;50(1):2-16.  https://doi.org/10.1016/j.anl.2022.05.002
  35. Ahmed J, Arya A. Lasers in Tonsillectomy: Revisited with Systematic Review. Ear, Nose and Throat Journal. 2021;100(1 Suppl):14S-18S.  https://doi.org/10.1177/0145561320961747
  36. Eski E, Dogan I, Yilmaz I. Seasonal variation of secondary post tonsillectomy hemorrhage rates. B-ENT. 2011;7(3):165-168. 
  37. Lee MS, Montague ML, Hussain SS. The influence of weather on the frequency of secondary post-tonsillectomy haemorrhage. The Journal of Laryngology and Otology. 2005;119(11):894-898.  https://doi.org/10.1258/002221505774783548
  38. Roberts C, Jayaramachandran S, Raine CH. A prospective study of factors which may predispose to post-operative tonsillar fossa haemorrhage. Clinical Otolaryngology and Allied Sciences. 1992;17(1):13-17.  https://doi.org/10.1111/j.1365-2273.1992.tb00980.x
  39. Grasl S, Mekhail P, Janik S, Grasl CM, Vyskocil E, Erovic BM, Arnoldner C, Landegger LD. Temporal fluctuations of post-tonsillectomy haemorrhage. European Archives of Oto-Rhino-Laryngology. 2022;279(3):1601-1607. https://doi.org/10.1007/s00405-021-07080-1
  40. Rosi-Schumacher M, Sharma J, Clausen S, Favre N, Powers K, Carr M. Post-tonsillectomy bleeding rate decreases with limitation in maximum post-operative ibuprofen dosage: A quality improvement study. American Journal of Otolaryngology. 2024;45(2):104197. https://doi.org/10.1016/j.amjoto.2023.104197
  41. Karpishchenko SA, Kolesnikova OM, Legkova YuV. Actual considerations of post-tonsillectomy case management. Russian Bulletin of Otorhinolaryngology. 2019;84(6):94-99. (In Russ.). https://doi.org/10.17116/otorino20198406194
  42. Kim DH, Stybayeva G, Hwang SH. Efficacy and safety of perioperative ibuprofen for pain control after pediatric tonsillectomy: A systemic review and meta-analysis. International Journal of Pediatric Otorhinolaryngology. 2024;184:112078. https://doi.org/10.1016/j.ijporl.2024.112078
  43. Kolb CM, Jain N, Schillinger K, Born K, Banker K, Aaronson NL, Nardone HC. Does perioperative ketorolac increase bleeding risk after intracapsular tonsillectomy? International Journal of Pediatric Otorhinolaryngology. 2021;147:110781. https://doi.org/10.1016/j.ijporl.2021.110781
  44. Yadav D, Dangol B, Shrestha N, Pandit S, Nepal A. Post-tonsillectomy Hemorrhage in Patients Receiving Ketorolac Analgesic. Kathmandu University Medical Journal (KUMJ). 2023;21(81):3-6. 
  45. Zaheer A, Majeed K, Sharif A, Bashir S, Khan A, Niwaz A. Comparison of intravenous ibuprofen and paracetamol for peri-operative analgesia in paediatric day care tonsillectomy. JPMA. The Journal of the Pakistan Medical Association. 2024;74(1):58-61.  https://doi.org/10.47391/JPMA.8155
  46. Mast G, Henderson K, Carr MM. The Effect of Ibuprofen Dosing Interval on Post-Tonsillectomy Outcomes in Children: A Quality Improvement Study. The Annals of Otology, Rhinology, and Laryngology. 2020;129(12):1210-1214. https://doi.org/10.1177/0003489420934843
  47. Suzuki S, Yasunaga H, Matsui H, Horiguchi H, Fushimi K, Yamasoba T. Impact of systemic steroids on posttonsillectomy bleeding: analysis of 61 430 patients using a national inpatient database in Japan. JAMA Otolaryngology—Head and Neck Surgery. 2014;140(10):906-910.  https://doi.org/10.1001/jamaoto.2014.2009
  48. Plante J, Turgeon AF, Zarychanski R, Lauzier F, Vigneault L, Moore L, Boutin A, Fergusson DA. Effect of systemic steroids on post-tonsillectomy bleeding and reinterventions: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;345:e5389. https://doi.org/10.1136/bmj.e5389
  49. Chen X, Liu W, Guo X, Zhou L, Liu W. Dexamethasone Decreased Postoperative Complications in Tonsillotomy. Journal of Perianesthesia Nursing. 2024;39(1):79-81.  https://doi.org/10.1016/j.jopan.2023.06.093
  50. Nosulia EV. Paratonsillitis. Russian Bulletin of Otorhinolaryngology. 2013;78(3):65-70. (In Russ.).
  51. Zloczower E, Netanely K, Shapira-Galitz Y, Pinhas S, Aharonovich N, Lahav Y, Allon R. Outcomes of abscess tonsillectomy in patients awaiting tonsillectomy: A comparison with interval tonsillectomy. American Journal of Otolaryngology. 2024;45(2):104198. https://doi.org/10.1016/j.amjoto.2023.104198
  52. Williamson A, Coleman H, Douglas C. Does infection play a role in post-tonsillectomy haemorrhage? A narrative review. The Journal of Laryngology and Otology. 2023;137(7):710-717.  https://doi.org/10.1017/S0022215122002547
  53. Tsikopoulos A, Fountarlis A, Tsikopoulos K, Dilmperis F, Garefis K, Tsikopoulos I, Skoulakis C, Karkos P, Triaridis S. Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology. 2022;279(5):2245-2257. https://doi.org/10.1007/s00405-022-07294-x
  54. Lehnerdt G, Senska K, Jahnke K, Fischer M. Post-tonsillectomy haemorrhage: a retrospective comparison of abscess- and elective tonsillectomy. Acta Otolaryngologica. 2005;125(12):1312-1317. https://doi.org/10.1080/00016480510012336
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