Y. Rakover et al., THE RISK OF POSTOPERATIVE HEMORRHAGE IN TONSILLECTOMY AS AN OUTPATIENT PROCEDURE IN CHILDREN, International journal of pediatric otorhinolaryngology, 41(1), 1997, pp. 29-36
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.