An audit of the complications of paediatric tonsillectomy, adenoidectomy and adenotonsillectomy

Abstract

Tonsillectomy, adenoidectomy and adenotonsillectomy are among the commonest surgical procedures undertaken in children. The notes of 413 consecutive children having tonsillectomy, adenoidectomy or adenotonsillectomy were analysed retrospectively to determine complication rates. Of the total number of children, 5.6% had at least one complication, the most common of which was haemorrhage occurring as a first complication in 3.9% (16 children). Three children with bleeding required active treatment (0.7%), one requiring transfusion and two requiring a return to theatre, all within 3 1/2 hours of operation. The incidence of reactionary bleeding was not associated with the grade or seniority of the surgeon. Six children (1.5%) developed a fever post-operatively, of which one required antibiotic treatment. On the basis of these results it is feasible for such procedures to be carried out on a day-care basis.

Day stay pediatric tonsillectomy—a safe procedure

“…The primary major hemorrhage incidence was 0.37% and primary minor hemorrhage incidence was 0.6% after day stay tonsillectomy in children. These incidences are comparable to those reported from British centers [11,12] that have a similar medical system to that in New Zealand. Hellier et al [11] reported a 0.3% incidence of major hemorrhage with a total primary hemorrhage rate of 0.97% during a period 1995-1997 (n = 928).…”

“…Kendrick and Gibbin [12] report a major hemorrhage incidence of 0.7% (n = 413). Although day stay tonsillectomy remains controversial in parts of Europe [11][12][13][14][15][16], experience has been gained in North America [7,8,[17][18][19][20][21][22][23][24][25]. Literature reviews suggest primary hemorrhage rates of 1-3% and secondary hemorrhage rates of 0.15-6.4% [26,27] Most series are small and depend on the definition of hemorrhage [28,29].…”

The use of perioperative antibiotics in tonsillectomy: Does it decrease morbidity?

“…Although these studies may have been useful in providing additional background information, they would not have been specifically useful for both, the qualitative and quantitative portions of this meta-analysis. On further review of the remaining 18 articles, 7 were withdrawn due to a lack of data regarding the primary clinical outcome of interest [9][10][11][12][13][14][15], and 5 were withdrawn due to the absence of a control 856 S. Iyer et al [16][17][18][19][20]. The seven remaining studies with usable information on post-operative outcomes of interest were included in the qualitative portion of this meta-analysis [21][22][23][24][25][26][27].…”

Post Tonsillectomy Haemorrhage In Bipolar Diathermy Versus Conventional Technique

“…None of the operative techniques seems to be significantly more prone to reactionary haemorrhage than the others. Likewise it's incidence is not related to grade and seniority of the surgeon [8] . A review on secondary haemorrhage suggests that it may be more common than widely appreciated, occurring in about 9% of cases.…”