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Would day-case adult tonsillectomy be safe?

Published online by Cambridge University Press:  29 June 2007

S. J. Moralee*
Affiliation:
Department of Otolaryngology, Level 4, Lauriston Building, Royal Infirmary, Edinburgh, EH3 9YW.
J. A. M. Murray*
Affiliation:
Department of Otolaryngology, Level 4, Lauriston Building, Royal Infirmary, Edinburgh, EH3 9YW.
*
Dr S. J. Moralee, Department of Otolaryngology, Lauriston Building, Royal Infirmary, Edinburgh, EH3 9YW.
Dr S. J. Moralee, Department of Otolaryngology, Lauriston Building, Royal Infirmary, Edinburgh, EH3 9YW.

Abstract

Day-case surgery is increasing to improve health care efficiency. Adult tonsillectomy is performed on an inpatient basis in the UK because of safety concerns regarding primary haemorrhage. This study aims to investigate the likely safety of day-case tonsillectomy in adults, by defining the incidence and timing of primary haemorrhage and therefore to establish a safe time period for same-day discharge.

Prospectively recorded data on 2 157 adult tonsillectomies over a five-year period were reviewed. Serious primary haemorrhage was uncommon (0.8 per cent). The 95 per cent reference range of time to primary haemorrhage was within 0 to 6.8 hours of surgery and the 95 per cent confidence interval (C.I.) of its upper limit was 5.2 to 8.4 hours. The results compare favourably with the UK inpatient and US adult day-case literature.

We conclude that day-case tonsillectomy would probably be safe in adults if the patients are discharged after 8.4 hours.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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References

Audit Commission for local authorities and the National Health Service in England and Wales. (1990) A short cut to better services. Day surgery in England and Wales. H.M.S.O., London, pp 5761.Google Scholar
Blair, R. L., McKerrow, W. S., Fenton, A. (1994) Draft: The Scottish Tonsillectomy Audit. Scottish Otolaryngological Society, pp 329.Google Scholar
Einthoven, A. C. (1985) Reflections on the management of the N.H.S. The Nuffield Provincial Hospitals Trust, London.Google Scholar
Helmus, C., Grin, M., Westfall, R. (1990) Same-day-stay adenotonsillectomy. Laryngoscope 100: 593596.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Kushner, H., Cozzi, L. (1989) Adenotonsillectomy a safe outpatient procedure. Archives of Otolaryngology — Head and Neck Surgery 115: 9294.CrossRefGoogle ScholarPubMed
Royal College of Surgeons of England's Commission on the Provision of Surgical Services. (1985) Guidelines for day case surgery. Royal College of Surgeons of England, London, pp 1819.Google Scholar
Tewary, A. K., Curry, A. R. (1993) Same-day tonsillectomy. Journal of Laryngology and Otology 107: 706708.CrossRefGoogle ScholarPubMed
Wagner, G. (1991) Ambulatory adult tonsillectomy. Journal of Otolaryngology 20: 1, 3334.Google ScholarPubMed
Watson, M. G., Dawes, P J. D., Samuel, P. R., Marshall, H. F., Rayappa, C., Hill, J., Meikle, D., Murty, G. E., Deans, J. A. J., Telios, G., Aldren, C., Birchall, J. P., Pritchard, A. J. N., Livesy, J., Appleton, D. (1993) A study of haemostasis following tonsillectomy comparing ligatures with diathermy. Journal of Laryngology and Otology 107: 711715.CrossRefGoogle ScholarPubMed
Yardley, M. P. J. (1992) Tonsillectomy, adenoidectomy and adenotonsillectomy: Are they safe day case procedures? Journal of Laryngology and Otology 106: 299300.CrossRefGoogle ScholarPubMed