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

Mahadevan, Murali; van der Meer, Graeme; Gruber, Maayan; Reed, Peter; Jackson, Conor; Brown, Colin; Mills, Nikki; Salkeld, Lesley J et al. · Laryngoscope · 2016

prospective_cohort · Level II

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Abstract

Tonsillectomy as a day-stay procedure remains controversial, although it is an established procedure in New Zealand. We reviewed our last 10 years' experience. A prospective audit was used to determine unplanned conversion from day-stay to overnight hospital admission rates and the incidence of postoperative complications. 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%). Day-stay tonsillectomy in the pediatric population is safe when performed using the described guidelines in a facility with appropriate resources. 4. Laryngoscope, 126:E416-E420, 2016.

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