Can Tonsillectomy Be Safely Performed by Residents? A Comparative Retrospective Study

Abstract

Objective: To assess whether a surgeon’s level of training is associated with outcomes in pediatric tonsillectomy. Design: A retrospective cohort study of the outcomes of pediatric tonsillectomies performed between 2006 and 2016 by senior surgeons versus resident surgeons under the supervision of senior surgeons. Setting: An otolaryngology department in a tertiary academic hospital. Patients: Children younger than 18 years who underwent bilateral tonsillectomy with or without adenoidectomy. Main outcome measures: Intraoperative bleeding, initiation of oral intake, and intraoperative and postoperative complications. Results: Of 785 children, 397 (50.5%) were operated on by a resident surgeon and 388 (49.5%) by a senior surgeon. Patient demographics and surgical techniques were similar between the groups. The mean surgical time was 33.2 minutes in the residents’ group and 27.1 minutes in the seniors’ group ( P = .032). The groups were similar in intraoperative bleeding, while same-day initiation of oral intake was 71% for children in the residents’ group versus 61% in the seniors’ group ( P = .28). Reports of postoperative bleeding necessitating readmission and revised operations were similar for both groups (3.0% and 0.7%, respectively, in the residents’ group; and 2.5% and 1.0%, respectively, in the seniors’ group). Conclusion: Children undergoing tonsillectomy showed similar short-term outcomes, whether the operations were performed by a senior surgeon or a resident surgeon supervised by an attending surgeon. This study demonstrates the safety of pediatric tonsillectomy performed by resident surgeons supervised by attending physicians.