Abstract
Background Tonsillectomy is one of the most commonly performed surgical procedures in children. It is performed for sleep-disordered breathing and infective symptoms. Despite advances in instrumentation and perioperative care, posttonsillectomy haemorrhage (PTH) remains a significant complication, which should be audited regularly. Methods A retrospective case series of all tonsillectomies performed in patients <15 years old in the Auckland region during 2017 was performed. Demographic, clinical, and surgical data were extracted and analysed. Univariate analysis was performed to compare patients with and without PTH. Results A total of 2177 tonsillectomies were performed during the study period, 64% in a public hospital and 36% in a private hospital. The overall PTH rate was 3.6% (0.23% occurring within the first 24 hours (primary) and 3.4% after 24 hours (secondary)). Mean time to PTH was 6.6 ± 3 days (range: 1-16 days). 90% of PTH occurred within the first 10 days and 99% by 14 days. Return to theatre was required in 28% of these cases, representing 1% of all tonsillectomies. There were no deaths or major complications in this cohort. The only differences observed between patients with PTH and those without were that children with PTH had smaller tonsils (p=0.004) and were less likely to have associated OME (p<0.001). Conclusion It is important to report institutional tonsillectomy outcomes and associated complications. These results show that PTH rates in Auckland remain within acceptable limits according to the literature.
Highlights
Tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population worldwide [1]. 530,000 children under the age of 15 years undergo tonsillectomy each year in the United States alone [2]
From January 1 to December 31 of 2017, a total of 2177 tonsillectomies were performed on paediatric patients in the Auckland Region
Tonsillectomy alone was performed in 15% (n=326) of cases, whereas all other surgeries included at least one additional procedure including adenoidectomy and inferior turbinate cautery. 64% (n=1395) of tonsillectomies were performed in a publicly funded hospital, with the remainder (36%, n=782) being performed in a private hospital
Summary
Tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population worldwide [1]. 530,000 children under the age of 15 years undergo tonsillectomy each year in the United States alone [2]. Children usually undergo tonsillectomy as a consequence of tonsillar hyperplasia or recurrent infection This can result in a broad spectrum of symptoms. Over the past several decades, sleep disordered breathing has become a much more common indication for tonsillectomy than recurrent tonsillitis [1] This is important as children with sleep disordered breathing symptoms who undergo tonsillectomy have a reported increased risk of postoperative hemorrhage and need for postoperative readmission to hospital [1, 3]. Tonsillectomy is one of the most commonly performed surgical procedures in children It is performed for sleepdisordered breathing and infective symptoms. It is important to report institutional tonsillectomy outcomes and associated complications These results show that PTH rates in Auckland remain within acceptable limits according to the literature
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