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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 4, pp 1211–1219 | Cite as

Safety of outpatient admission and comparison of different surgical techniques in adult tonsillectomy

  • Mehmet Eser SancaktarEmail author
  • Mehmet Çelebi
  • Mahmut Yıldırım
  • Erkan Can
  • Gökhan Akgül
  • İbrahim Ağrı
  • Asude Ünal
  • Fatih Yılmaz
Head & Neck

Abstract

Purpose

To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients.

Methods

The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded.

Results

A total of 276 patients met the inclusion criteria, comprising 139 (50.4%) females and 137 (49.6%) males with a mean age of 27.17 ± 9.41 years. The most common indication was recurrent tonsillitis (n = 223, 80.8%), and surgical techniques used were bipolar scissors (CURIS®, Sutter Medizintechnik, Germany) (n = 137, 49.6%), cold dissection (n = 75, 27.2%) and/or plasma blade (PEAK Surgical, Medtronic, USA) (n = 64, 23.2%). A total of 43 (15.5%) re-admissions from 37 (13.4%) patients were recorded because of bleeding (n = 33, 70.2%) and/or odynodysphagia (n = 13, 27.7%). Non-surgical interventions were sufficient in 32 (74.4%) cases, while surgical interventions were required in 11 (25.6%) patients. In patients where “hot” techniques (bipolar scissors, plasma blade) were used and in patients with complaints in the first 24 h postoperatively, significantly increased rates of elongated LOS values for more than 1 day were determined (p < 0.01, p < 0.001).

Conclusions

Adult tonsillectomy is a safe surgical procedure with low complication, re-operation and mortality rates. Significantly increased rates of elongated LOS values for more than 1 day and re-admissions after discharge were determined in those patients having complications in the first 24 h postoperatively. Cold dissection seems to be more advisable than hot techniques for outpatient tonsillectomy among adult patients.

Keywords

Adult tonsillectomy Outpatient tonsillectomy Safe surgery Surgical technique 

Notes

Acknowledgements

The authors are grateful to Tuğba Altundal and İlker Oral Çırakoğlu for their valuable assistance with the data collection and to the statistician Damla Kirendibi Kökgöz for contributing to the statistical analyses of the study.

Funding

The authors have no funding to disclose.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was a retrospective data analysis study and it did not need informed consent. This retrospective study was performed with the approval of the local ethics committee.

Human and animal rights statement

The study has been performed according to the ethical standards of the Helsinki Declaration. We declare that all authors have contributed to it, read and approved the final manuscript for submission.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology-Head and Neck Surgery, Samsun Training and Research HospitalUniversity of Medical Sciences, Ministry of HealthSamsunTurkey
  2. 2.Department of Otorhinolaryngology-Head and Neck Surgery, Bozyaka Training and Research HospitalUniversity of Medical Sciences, Ministry of HealthIzmirTurkey
  3. 3.SamsunTurkey
  4. 4.SamsunTurkey
  5. 5.SamsunTurkey
  6. 6.SamsunTurkey
  7. 7.SamsunTurkey
  8. 8.SamsunTurkey
  9. 9.SamsunTurkey
  10. 10.IzmirTurkey

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