Outpatient tonsillectomy in children: a systematic review.

Abstract

To evaluate the level of evidence regarding the safety of outpatient pediatric tonsillectomy. The medical literature addressing outpatient pediatric tonsillectomy was systematically reviewed. The level of evidence was assessed, and data were pooled. Seventeen articles met inclusion criteria. Each article suggested that outpatient tonsillectomy was safe. The overall level of evidence was fair (grade B-). Pooled data analysis in the perioperative period showed a complication rate estimate of 8.8% (95% confidence interval [CI], 5.5%-12.1%; P < or = 0.001) and an unplanned admission rate estimate of 8.0% (95% CI, 5.3%-10.7%; P < or = 0.001). Subgroup analysis suggests that children under age 4 are at a higher risk of complications in the perioperative period with an odds ratio of 1.64 (95% CI, 1.16-2.31). The level of evidence supporting the safety of outpatient pediatric tonsillectomy is fair. The analyzed data show a higher rate of early complications and unplanned admissions in children under age 4. The current evidence supports the practice of outpatient tonsillectomy in properly selected children. A-1a.