The Case for an Outpatient “Approach” for All Pediatric Tonsillectomies and/or Adenoidectomies: A 4-Year Review of 1419 Cases at a Community Hospital

Abstract

OBJECTIVE: We sought to document the safety and efficacy of approaching all pediatric tonsillectomies and/or adenoidectomies (T/A) as outpatient procedures. STUDY DESIGN AND SETTING: We conducted a 4-year retrospective study of 1419 pediatric patients undergoing T/A at an outpatient center with procedures performed by a single group of surgeons. RESULTS: None of the 593 patients undergoing an adenoidectomy and only 5 (0.6%) of those having a tonsillectomy had significant bleeding postoperatively. There were no readmissions for airway problems. Children younger than age 3 were most likely to have complications and to be held for overnight observations. CONCLUSIONS: Most children can be safely discharged after T/A. The higher incidence of perioperative complications in children who are younger than 3 years of age paralleled their higher rate of overnight observation. SIGNIFICANCE: Children less than 3 years of age require more careful observation, especially after tonsillectomy and more likely will need to be observed overnight than older children.