Safety of outpatient admission and comparison of different surgical techniques in adult tonsillectomy

• Published in: European archives of oto-rhino-laryngology 2019-04, Vol.276 (4), p.1211-1219
• Main Authors: Sancaktar, Mehmet Eser, Çelebi, Mehmet, Yıldırım, Mahmut, Can, Erkan, Akgül, Gökhan, Ağrı, İbrahim, Ünal, Asude, Yılmaz, Fatih
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ambulatory Care; Dissection - adverse effects; Female; Head & Neck; Head and Neck Surgery; Hospitalization; Humans; Length of Stay; Male; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology; Postoperative Complications - epidemiology; Reoperation; Tonsillectomy - adverse effects; Tonsillectomy - methods; Tonsillitis - surgery; Young Adult
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-019-05334-7

Purpose To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients. Methods The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded. Results A total of 276 patients met the inclusion criteria, comprising 139 (50.4%) females and 137 (49.6%) males with a mean age of 27.17 ± 9.41 years. The most common indication was recurrent tonsillitis ( n  = 223, 80.8%), and surgical techniques used were bipolar scissors (CURIS ® , Sutter Medizintechnik, Germany) ( n  = 137, 49.6%), cold dissection ( n  = 75, 27.2%) and/or plasma blade (PEAK Surgical, Medtronic, USA) ( n  = 64, 23.2%). A total of 43 (15.5%) re-admissions from 37 (13.4%) patients were recorded because of bleeding ( n  = 33, 70.2%) and/or odynodysphagia ( n  = 13, 27.7%). Non-surgical interventions were sufficient in 32 (74.4%) cases, while surgical interventions were required in 11 (25.6%) patients. In patients where “hot” techniques (bipolar scissors, plasma blade) were used and in patients with complaints in the first 24 h postoperatively, significantly increased rates of elongated LOS values for more than 1 day were determined ( p