Tonsillectomy as a day-case surgery: a safe procedure?

Tonsillectomy as a day-case surgery: a safe procedure? Problem/objectives: To assess the safety of tonsillectomy as a one-day procedure, we retrospectively evaluated complications of tonsillectomy within two weeks after surgery.

Methodology: The study included 1977 patients; 85% of the tonsillectomies were performed as a one-day procedure. Tonsillectomies were performed in Ziekenhuis Oost Limburg by one staff ENT and seven ENT residents between January 1, 1996 and January 1, 2005. We also reviewed the number of tonsillectomies performed as day surgery and their complication rate for Belgium, based on the National Office for Health and Disability Insurance billing, comparing our series with the number of tonsillectomies as day-case surgeries and their complication rate for Belgium.

Results: In our study, 26 patients (1.3%) consulted within two weeks of surgery for major or minor complications secondary to tonsillectomy. The only major complication was primary bleeding (bleeding within 24 hours after tonsillectomy), which occurred in five patients, all of whom received a revision for haemostasis. No patient required transfusion. Minor complications (21 patients) were secondary bleeding, fever, and anorexia. During the study period, there were 214,524 tonsillectomies performed in Belgium. Based on invoice information, 4676 cases of postoperative bleeding occurred, requiring a revision for haemostasis. In our centre and generally for Belgium, there was an increase in tonsillectomies as an outpatient procedure without an increase in incidence of subsequent bleeding. Day-case surgery tonsillectomy incidence had risen from 36% in 1996 to 64% in 2004 in Belgium.

Conclusion: Considering the low bleeding and complication rates, tonsillectomy can safely be performed as a day-case surgery.