ABSTRACT
Objective Day case tonsillectomy is standard practice in many international centres, and is widespread across the UK. In Ireland, implementation has been slow for multiple reasons. Our unit aimed to introduce day case tonsillectomy, following a pilot programme. Following a year of implementation we have reaudited our practice. We hypothesised that day case tonsillectomy is a practical and favourable solution to facilitate access to surgery in the context of long waiting times for ENT surgery. Methods This was a prospective audit collecting data on day case tonsillectomy. All patients for day case tonsillectomy were selected in OPD according to our inclusion criteria. We recorded demographical data, surgical technique, length of stay, failed discharges, bleeding rate and readmission rate. Results There was one primary haemorrhage within 24 hours of surgery (0.08%). There were 16 secondary bleeds, giving a rate of 13.9%. Of these, four patients required a return to theatre for the cessation of bleeding (3.5%). There was no statistical significance in bleed rate between surgical technique. Failed discharge rate was 6%. The average time from extubation to discharge was 6 hours and 53 minutes. Conclusions Our experience of day case tonsillectomy is that it is safe, feasible and efficient in a selected group of patients. This can expedite long waiting times for tonsillectomy, and improve access to overnight beds for other cases. Our numbers represent the first unit in Ireland to have 2 year of experience with data showing successful implementation.
Subject(s)
Tonsillectomy , Ambulatory Surgical Procedures , Humans , IrelandABSTRACT
OBJECTIVE: To assess parent or guardian satisfaction with a newly instituted day-case tonsillectomy programme at a tertiary paediatric institution. METHODS: After receiving ethical approval, an anonymous questionnaire was sent to the parent or guardian of every patient who underwent day-case tonsillectomy between July 2018 and December 2020. RESULTS: A total of 135 patients were included. The parent or guardian of each patient was sent a questionnaire to be filled in and returned. Ninety-two completed surveys were returned. There were high satisfaction levels, with 91.3 per cent of parents or guardians feeling comfortable bringing their child home, and 92.4 per cent of parents or guardians would recommend day-case tonsillectomy to another parent or guardian. Of the parents or guardians, 10.9 per cent needed to contact healthcare services in the 24 hours following surgery. CONCLUSION: Day-case tonsillectomy has proven to be a safe, efficient service at our institution, with high satisfaction levels from patients and parents or guardians. Areas for improvement focused on communication at the time of discharge regarding follow up and analgesia.
