The starship children's hospital tonsillectomy: A further 10 years of experience

Laryngoscope. 2016 Dec;126(12):E416-E420. doi: 10.1002/lary.26041. Epub 2016 Apr 27.

Abstract

Objectives/hypothesis: Tonsillectomy as a day-stay procedure remains controversial, although it is an established procedure in New Zealand. We reviewed our last 10 years' experience.

Methods: A prospective audit was used to determine unplanned conversion from day-stay to overnight hospital admission rates and the incidence of postoperative complications.

Results: There were 5,400 tonsillectomies performed over the 10-year study period (January 2004-January 2015); 71% as outpatients. The unplanned conversion rate to overnight stay was 0.4%. The median age of day-stay patients was 6.5 years (range 13 months-15 years) compared with those admitted for overnight stay (5 years; range 8 months-15 years). The primary postoperative bleed rate was 0.5% (confidence interval [CI] 0.3%-0.7%), and the combined primary and secondary posttonsillectomy bleed rate was 4.3% (CI 3.8%-5.0%). The rate of patients returning with postoperative complications within 1 month of surgery was 6.3% (CI 5.6%-7.0%).

Conclusion: Day-stay tonsillectomy in the pediatric population is safe when performed using the described guidelines in a facility with appropriate resources.

Level of evidence: 4. Laryngoscope, 126:E416-E420, 2016.

Keywords: Tonsillectomy; day stay surgery; hemorrhage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Surgical Procedures / adverse effects*
  • Child
  • Hospitalization*
  • Hospitals, Pediatric
  • Humans
  • Length of Stay
  • New Zealand
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Nausea and Vomiting / epidemiology
  • Prospective Studies
  • Tonsillectomy / adverse effects*
  • Tonsillectomy / methods