Evaluation of day-care tonsil surgery in young children

INTRODUCTION: The National Clinical Guideline for Tonsillectomy (Danish Health Authority, 2016) suggests inpatient admission after elective tonsil surgery in patients aged < 4 years at the time of surgery. We aimed to evaluate the safety of tonsil surgery as day surgery in children ≤ 4 years of age. METHODS: The charts of 414 patients aged 2-15 years who underwent elective tonsillectomy, adenotonsillectomy or tonsillotomy at Svendborg Hospital, Denmark, from February 2010 to April 2015 were reviewed in a retrospective cohort. We investigated post-operative complications, defined as post-operative haemorrhage and unplanned contacts or revisits to the hospital. RESULTS: A total of 389 patients were divided into two groups by age (≤ 4/>4 years). In all, 108 patients contacted or revisited the hospital after discharge. Patients aged < 4 years accounted for the majority of contacts unrelated to bleeding and associated with complaints of pain and pain medication. Haemorrhage occurred in 22 (5.7%) patients, 19 of whom were > 4 years. The rates of haemorrhage, readmission and secondary surgery were significantly higher in patients aged > 4 years than in the remaining patients. CONCLUSIONS: Patients ≤ 4 years experienced significantly less haemorrhage but had more unplanned contacts than patients > 4 years. For reassurance of caretakers, easy access to telephone contact with hospital staff in the post-operative period is important.