Tonsillectomy is the most common major surgical procedure performed in children. Children who undergo the surgical removal of their tonsils, with or without the removal of their adenoids, are at increased risk for becoming overweight after surgery, according to new research published in an issue of Otolaryngology – Head and Neck Surgery.
Paediatric obesity has increased overwhelmingly over the last 20 years, with recent data suggesting that as many as 33% of children are overweight and 17% obese. Obese children are at increased risk of becoming obese adults, thus making them susceptible to cardiovascular disease and diabetes.
The study sample included 795 children aged 0 to 18 years old, described as normal weight or overweight and who had tonsillectomy or adenotonsillectomy surgery.
In 47.7% of patients, the primary reason for surgery was sleep-disordered breathing.
Parents over-feed kids after surgery
The first group included three studies involving 127 children, whose body mass index (BMI) increased by 5.5-8.2%. The second group included three studies involving 419 patients, in whom the standardised weight scores increased in 46-100% patients.
The third group included three studies with 249 patients, in whom 50 – 75% of the patients gained weight after adenoidectomy. Each study was designed with different definitions of overweight and a range of follow-up periods.
"There may have been a variety of proposed mechanisms for the weight gain following adenoidectomy," writes author Anita Jeyakumar, MD. "Children with chronic tonsillitis may have dysphagia or odynophagia that may lead to a reduced kilojoule intake.
When the diseased tonsils are removed, the child then is able to consume additional kilojoules. Parents may also feel impelled to over-feed their child when recovering from chronic illness or surgery, further adding to more kilojoue intake and weight gain."
Based on these findings, the authors recommend that dietary and lifestyle advice be given to parents whose children are undergoing tonsillectomy. Growth monitoring after surgery is key to ensure that catch-up growth occurs within healthy limits.
(EurekAlert, February 2011)