Effect of nasal endoscopic-assisted low temperature plasma resection on traumatic stress and CC chemokines in children with tonsil and adenoidal hypertrophy

Objective To investigate the effect of nasal endoscopic-assisted low temperature plasma resection on traumatic stress and CC chemokines in children with tonsil and adenoidal hypertrophy.

Methods A total of 120 children with tonsil or adenoidal hypertrophy were prospectively enrolled. They were randomly divided into observation group and control group, with 60 cases in each group. The observation group was performed nasal endoscopic-assisted low temperature plasma tonsillectomy or adenoidectomy, while the control group was performed routine tonsillectomy combined with adenoidectomy under nasal endoscope. Surgery-related indicators (operative time, intraoperative blood loss, recovery to normal diet time and complete regression time of tunica albuginea), Visual Analogue Scale (VAS) score were compared between the two groups; traumatic stress indicatorsprocalcitonin (PCT), Cortisol(Cor), prostaglandin E2(PGE2) and prostaglandin F2α(PGF2α), CC chemokines(CCL2 and CCL21) and total incidence of postoperative complications were analyzed between the two groups.

Results The operation time and normal diet time of the observation group were significantly shorter, and the intraoperative blood loss was significantly less than that of the control group (P < 0.05). At 1 day, 3, 5 days after operation, the VAS pain scores in the observation group were significantly lower than those in the control group (P < 0.05). At 1 day, 3 days after operation, the serum levels of CCL2 in observation group were significantly higher, the serum levels of PCT, Cor, PGE2, PGF2α and CCL21 in the observation group were significantly lower than those in the control group (P < 0.05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (P < 0.05).

Conclusion The nasal endoscopic-assisted low temperature plasma resection has less trauma and lower overall incidence of complications, which can effectively relieve postoperative pain and reduce the traumatic stress response and degree of CC chemokine mediated immune inflammatory response.