Safety of outpatient admission and comparison of different surgical techniques in adult tonsillectomy
To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients.
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.
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).
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.
KeywordsAdult tonsillectomy Outpatient tonsillectomy Safe surgery Surgical technique
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.
The authors have no funding to disclose.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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.
- 6.Chen MM, Roman SA, Sosa JA et al (2014) Safety of adult tonsillectomy: a population-level analysis of 5968 patients. Otolaryngol Head Neck Surg 140(3):197–202Google Scholar
- 10.Hall MJ, Schwartzman A, Zhang J et al (2017) Ambulatory Surgery Data From Hospitals and Ambulatory Surgery Centers: United States, 2010. Natl Health Stat Rep 102:1–15Google Scholar
- 11.Pinder DK, Wilson H, Hilton MP (2011) Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev 3:CD002211Google Scholar
- 12.Coordes A, Soudry J, Hofmann VM et al (2015) Tonsillectomy in adults: LOS has no influence on the frequency of postoperative hemorrhage. HNO 63(12):841–844, 846–849Google Scholar
- 17.Ovesen T, Kamarauskas A, Hlidarsdottir T et al (2013) Good long-term results after tonsillectomy in ear, nose and throat practices. Dan Med J 60:A4637Google Scholar
- 19.Bhattacharyya N (2001) Evaluation of post-tonsillectomy bleeding in the adult population. Ear Nose Throat J 80(8):544–549Google Scholar