THE RISK OF POSTOPERATIVE HEMORRHAGE IN TONSILLECTOMY AS AN OUTPATIENT PROCEDURE IN CHILDREN

The safety of performing tonsillectomy as an outpatient procedure is s till questionable. This study determined whether there was an increase d risk of postoperative bleeding by performing tonsillectomy as an out patient procedure. A six years' retrospective chart review was made of 363 children who underwent tonsillectomy. Out of 363 children, 43 had been selected as an inpatient group before the operation, 264 patient s were discharged home 6 h after the operation and were the outpatient group, and 56 children had to be kept overnight because of complicati ons that had occurred. We compared the haemorrhage rate in the outpati ent and the inpatient groups. We found no increase in the postoperativ e haemorrhage rate in the outpatient group. No statistically significa nt correlations were found between the children's ages, indication for surgery, type of operation or intra-operative complications and the r isk of postoperative haemorrhage. Only children who had haemorrhage in the recovery room were identified as a high risk subgroup for recurre nt bleeding. On the basis of our findings we believe that tonsillectom y can be performed as an outpatient procedure regardless of age,:indic ation for surgery, or type of procedure, as long as good recovery room supervision exists for 4 to 6 h. (C) 1997 Elsevier Science Ireland Lt d.