Paediatric ENT day surgery: Is it safe practice?

Abstract

Day-case surgery is convenient and safe allowing patients to have the appropriate medical service without long waits. The issue of safety has been extensively studied and presented in the literature. In this paper, the Security Forces Hospital experience with otolaryngology day-surgery cases is presented. Objective To evaluate the rate of complications and their timing and to assess the safety of day-surgery procedures. Methods A total of 300 children undergoing tonsillectomy, adenotonsillectomy, adenoidectomy, myringotomy, and other minor surgeries (e.g. reduction of fracture nasal bone, foreign body removal, etc.) were observed. Post-operatively after recovery from anaesthesia, a number of parameters were recorded at intervals of 15 min for the first 4 h, 30 min for the following 3 h, and hourly until discharge. Bleeding was considered to have occurred only if medical attention was required. Results In the evaluation of haemorrhage as an important complication, nine cases (3%) bled in the first 6 h (six following adenoidectomy and three following tonsillectomies) after day-surgery procedures, while six cases bled after 3 days (2%). Results were compared with post-operative haemorrhage after operations done in the main OR and there it was reported in 11 out of 101 cases in whom adenotonsillectomy was performed: only one patient (1%) needed control in the OR. Conclusion Post-operative complications after day-surgery procedures are comparable to that after main OR procedures. The common paediatric ENT procedures, e.g. adenoidectomy, tonsillectomy, adenotonsillectomy, and myringotomy, can be done safely as day-case procedures in a busy hospital.