{{위키데이터 속성 추적}}
{{Infobox medical intervention
|  name        = 편도절제술
|  synonyms    = T&A
|  image       = Tonsillectomy09.jpg
|  caption     = 편도절제술 3일 후 인후 뒤쪽의 모습
|  ICD10       = 
|  ICD9        = {{ICD9proc|28.2}}-{{ICD9proc|28.3}}
|  MeshID      = D014068
|  MedlinePlus = 003013
|  OPS301      = 
|  OtherCodes  = 
}}
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'''편도절제술'''(tonsillectomy, 扁桃切除術)은 [[인후]] 뒤쪽에서 양쪽 [[구개편도]]를 완전히 제거하는 [[수술 (의학)|수술]]이다.<ref name=Oto2019>{{저널 인용|last1=Mitchell |first1=Ron B. |last2=Archer |first2=Sanford M. |last3=Ishman |first3=Stacey L. |last4=Rosenfeld |first4=Richard M. |last5=Coles |first5=Sarah |last6=Finestone |first6=Sandra A. |last7=Friedman |first7=Norman R. |last8=Giordano |first8=Terri |last9=Hildrew |first9=Douglas M. |last10=Kim |first10=Tae W. |last11=Lloyd |first11=Robin M. |last12=Parikh |first12=Sanjay R. |last13=Shulman |first13=Stanford T. |last14=Walner |first14=David L. |last15=Walsh |first15=Sandra A. |last16=Nnacheta |first16=Lorraine C. |title=Clinical Practice Guideline: Tonsillectomy in Children (Update) |journal=Otolaryngology–Head and Neck Surgery |date=5 February 2019 |volume=160 |issue=1_suppl |pages=S1–S42 |doi=10.1177/0194599818801757|pmid=30798778 |doi-access=free }}</ref> 재발성 [[편도염]], [[인후염]], [[폐쇄성 수면 무호흡증]] 등이 있는 경우에 주로 수행한다.<ref name=Oto2019/> 인후에 감염이 자주 발생하는 사람들의 경우 편도절제술을 받으면 이듬해에 감염이 일어날 가능성이 줄어들지만 장기적인 이득이 있다는 근거는 아직 존재하지 않는다.<ref name=Oto2019/><!-- quote = tonsillectomy for recurrent throat infections in severely affected children was shown, in a randomized controlled trial, to reduce the frequency (one fewer sore throat) and severity of infections ()

We combined data from five trials in children; these trials included children who were 'severely aHected' (based on the specific 'Paradise'
criteria) and less severely aHected. Children who had an adeno-/tonsillectomy had an average of three episodes of sore throats (of any
severity) in the first postoperative year, compared to 3.6 episodes in the control group; a diHerence of 0.6 episodes (95% confidence interval
(CI) -1 to -0.1; moderate quality evidence). One of the three episodes in the surgical group was the 'predictable' one that occurred in the
immediate postoperative period.
When we analysed only episodes of moderate/severe sore throat, children who had been more severely aHected and had adeno-/
tonsillectomy had on average 1.1 episodes of sore throat in the first postoperative year, compared with 1.2 episodes in the control group
(low quality evidence). This is not a significant diHerence but one episode in the surgical group was that occurring immediately aLer
surgery.

in the first year following surgery --><ref name=Burton2014>{{저널 인용| vauthors = Burton MJ, Glasziou PP, Chong LY, Venekamp RP | title = Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis | journal = The Cochrane Database of Systematic Reviews | issue = 11 | pages = CD001802 | date = November 2014 | pmid = 25407135 | doi = 10.1002/14651858.CD001802.pub3| pmc = 7075105 |quote=Adeno-/tonsillectomy leads to a reduction in the number of episodes of sore throat and days with sore throat in children in the first year after surgery compared to (initial) non-surgical treatment. | url = https://pure.bond.edu.au/ws/files/32844113/Tonsillectomy_or_adenotonsillectomy_versus_non_surgical_treatment_for_chronic.pdf }}</ref> 폐쇄성 수면 무호흡증이 있는 어린이의 경우 편도절제술을 받으면 [[삶의 질]]이 개선되는 효과가 있다.<ref name=Ven2015>{{저널 인용| vauthors = Venekamp RP, Hearne BJ, Chandrasekharan D, Blackshaw H, Lim J, Schilder AG | title = Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children | journal = The Cochrane Database of Systematic Reviews | issue = 10 | pages = CD011165 | date = October 2015 | volume = 2015 | pmid = 26465274 | doi = 10.1002/14651858.CD011165.pub2 | pmc = 9242010 | url = http://dspace.library.uu.nl/bitstream/1874/335868/1/Venekamp.pdf }}</ref>

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편도절제술은 일반적으로 안전한 수술이지만 합병증으로 [[출혈]], [[구토]], [[탈수]], 먹거나 말하는 데의 문제 등이 생길 수 있다.<ref name=Oto2019/> [[인후통]]은 보통 수술 이후 1 ~ 2주 정도 지속된다.<ref name=Oto2019/><ref>{{서적 인용|last1=Flint |first1=Paul W. |last2=Haughey |first2=Bruce H. |last3=Robbins |first3=K. Thomas |last4=Thomas |first4=J. Regan |last5=Niparko |first5=John K. |last6=Lund |first6=Valerie J. |last7=Lesperance |first7=Marci M. |title=Cummings Otolaryngology – Head and Neck Surgery E-Book |date=2014 |publisher=Elsevier Health Sciences |isbn=9780323278201 |page=2862 |url=https://books.google.com/books?id=lFajBQAAQBAJ&pg=PA2862 |language=en}}</ref> 출혈은 수술 첫날 전체 환자의 1%, 그 이후에는 2% 가량에서 발생한다.<ref name=Oto2019/> 수술 중 사망은 2,360건 ~ 56,000건 당 1건이 발생한다고 보고되고 있다.<ref name=Oto2019/> 편도절제술은 장기적인 [[면역계|면역 기능]]에는 영향을 끼치지 않는다고 알려져 있다.<ref name=Oto2019/><!-- quote = Nevertheless, there are no studies to date that demonstrate a significant clinical impact of tonsillectomy on the immune system. --><ref name=Bit2015>{{저널 인용|last1=Bitar |first1=MA |last2=Dowli |first2=A |last3=Mourad |first3=M |title=The effect of tonsillectomy on the immune system: A systematic review and meta-analysis. |journal=International Journal of Pediatric Otorhinolaryngology |date=August 2015 |volume=79 |issue=8 |pages=1184–91 |doi=10.1016/j.ijporl.2015.05.016 |pmid=26055199}}</ref>

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수술 후 통증을 줄이기 위해 [[이부프로펜]]이나 [[파라세타몰]](아세트아미노펜)을 사용할 수 있다.<ref name=Oto2019/> 다양한 철제 [[수술기구]]와 [[전기소작기]]가 수술에 쓰인다.<ref name=Oto2019/><ref name=Dam2016>{{저널 인용|last1=Damiani |first1=F |last2=Rada |first2=G |last3=Gana |first3=JC |last4=Brockmann |first4=PE |last5=Alberti |first5=G |title=Long-term effects of adenotonsillectomy in children with obstructive sleep apnoea: protocol for a systematic review. |journal=BMJ Open |date=2 September 2016 |volume=6 |issue=9 |pages=e010030 |doi=10.1136/bmjopen-2015-010030 |pmid=27591015|pmc=5020755 }}</ref> [[아데노이드]]를 같이 제거하기도 하며 이때는 '''아데노이드편도절제술'''(adenotonsillectomy)이라고 한다.<ref name=Oto2019/> 구개편도를 부분적으로 잘라내는 경우에는 'tonsilotomy'(편도 일부의 제거)라는 용어를 사용하기도 하며, 폐쇄성 수면 무호흡증에서는 이쪽을 더 선호하기도 한다.<ref name=Oto2019/><ref>{{저널 인용|last1=Zhang|first1=Lai-Ying|last2=Zhong|first2=Laurie|last3=David|first3=Michael|last4=Cervin|first4=Anders|date=December 2017|title=Tonsillectomy or tonsillotomy? A systematic review for paediatric sleep-disordered breathing|journal=International Journal of Pediatric Otorhinolaryngology|language=en|volume=103|pages=41–50|doi=10.1016/j.ijporl.2017.10.008|pmid=29224763}}</ref><ref>{{저널 인용|last1=Gorman|first1=D.|last2=Ogston|first2=S.|last3=Hussain|first3=S. S. M.|date=2017|title=Improvement in symptoms of obstructive sleep apnoea in children following tonsillectomy versus tonsillotomy: a systematic review and meta-analysis|journal=Clinical Otolaryngology|language=en|volume=42|issue=2|pages=275–282|doi=10.1111/coa.12717|pmid=27506317|s2cid=1784671|issn=1749-4486}}</ref><ref name=Ste2014>{{저널 인용|last=Stelter|first=Klaus|date=2014-12-01|title=Tonsillitis and sore throat in children|journal=GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery|volume=13|pages=Doc07|doi=10.3205/cto000110|issn=1865-1011|pmc=4273168|pmid=25587367}}</ref>

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편도절제술이 처음 기술된 것은 기원후 50년 [[켈수스]](Celsus)의 기록까지 거슬러 올라간다.<ref>{{저널 인용|last1=Lamprell |first1=L |last2=Ahluwalia |first2=S |title=Who has been hiding in your tonsillectomy tray? Eponymous instruments in tonsillectomy surgery. |journal=The Journal of Laryngology and Otology |date=April 2015 |volume=129 |issue=4 |pages=307–13 |doi=10.1017/S0022215114003016 |pmid=25658777|s2cid=42461145 }}</ref> 2010년 기준 미국에서 편도절제술은 1970년대보다 적게 시행되었으나, 여전히 어린이에게 시행된 [[외래 수술]] 중 두 번째로 많은 수를 차지했다.<ref name=Oto2019/> [[입원]] 환자를 기준으로 수술 비용은 미국에서 2013년 기준 4,400[[미국 달러|달러]]로 집계되었다.<ref>{{저널 인용|last1=Sun |first1=GH |last2=Auger |first2=KA |last3=Aliu |first3=O |last4=Patrick |first4=SW |last5=DeMonner |first5=S |last6=Davis |first6=MM |title=Variation in inpatient tonsillectomy costs within and between US hospitals attributable to postoperative complications. |journal=Medical Care |date=December 2013 |volume=51 |issue=12 |pages=1048–54 |doi=10.1097/MLR.0b013e3182a50325 |pmid=23969585|s2cid=22239630 }}</ref> 한편 [[건강보험심사평가원]]에 따르면 2010년 기준 대한민국에서 편도선 수술의 가격은 최소 44만 원, 최대 122만 원으로 집계되었다.<ref>{{뉴스 인용|url=https://www.hkn24.com/news/articleView.html?idxno=40764|제목=편도선 수술 비싼 병원 1~4위 ‘지방병원’ 석권|성=이상훈|날짜=2010-01-25|뉴스=헬스코리아뉴스|확인날짜=2023-03-05}}</ref> 경과 관찰이나 내과적 치료와 비교했을 때 수술의 필요성에 대해서는 2019년 기준으로도 여전히 일부 논쟁이 있다.<ref name=Oto2019/><!-- Quote = Controversy persists regarding the actual benefits of tonsillectomy as compared with observation and medical treatment of throat infections. --><ref name="Burton2014" /><!-- Quote = but the indications for surgery are controversial --> 나라마다 편도절제술이 시행되는 비율에는 차이가 있다.<ref name=EU2019>{{웹 인용|url=https://ec.europa.eu/eurostat/statistics-explained/index.php/Surgical_operations_and_procedures_statistics#Number_of_surgical_operations_and_procedures|title=Surgical operations and procedures statistics - Statistics Explained|website=ec.europa.eu|access-date=2019-10-08}}</ref><ref name=Sul2010>{{저널 인용| vauthors = Suleman M, Clark MP, Goldacre M, Burton M | title = Exploring the variation in paediatric tonsillectomy rates between English regions: a 5-year NHS and independent sector data analysis | journal = Clinical Otolaryngology | volume = 35 | issue = 2 | pages = 111–7 | date = April 2010 | pmid = 20500580 | doi = 10.1111/j.1749-4486.2010.02086.x | s2cid = 31719394 }}</ref>

== 각주 ==
{{각주}}

== 외부 링크 ==
* {{위키공용분류-줄}}
* [http://www.entnet.org/HealthInformation/tonsillectomyProcedures.cfm Tonsillectomy Procedures] {{웨이백|url=http://www.entnet.org/HealthInformation/tonsillectomyProcedures.cfm |date=20080705102609 }}
* [https://www.scribd.com/full/27709493?access_key=key-2dietfgd7y5jsmla9vpx History of tonsillectomy]
* {{저널 인용| title = Clinical UM Guideline CG-SURG-30: Tonsillectomy for Children | url = http://www.bcbsga.com/medicalpolicies/guidelines/gl_pw_c148461.htm | journal =  Blue Cross Blue Shield Association of Georgia }}

{{전거 통제}}

[[분류:절제술]]
[[분류:편도]]