Outpatient tonsillectomy in children: a systematic review.
OBJECTIVE
To evaluate the level of evidence regarding the safety of outpatient pediatric tonsillectomy.


METHODS
The medical literature addressing outpatient pediatric tonsillectomy was systematically reviewed. The level of evidence was assessed, and data were pooled.


RESULTS
Seventeen articles met inclusion criteria. Each article suggested that outpatient tonsillectomy was safe. The overall level of evidence was fair (grade B-). Pooled data analysis in the perioperative period showed a complication rate estimate of 8.8% (95% confidence interval [CI], 5.5%-12.1%; P < or = 0.001) and an unplanned admission rate estimate of 8.0% (95% CI, 5.3%-10.7%; P < or = 0.001). Subgroup analysis suggests that children under age 4 are at a higher risk of complications in the perioperative period with an odds ratio of 1.64 (95% CI, 1.16-2.31).


CONCLUSIONS
The level of evidence supporting the safety of outpatient pediatric tonsillectomy is fair. The analyzed data show a higher rate of early complications and unplanned admissions in children under age 4.


CONCLUSIONS
The current evidence supports the practice of outpatient tonsillectomy in properly selected children.


METHODS
A-1a.
Brigger
Matthew T
MT
Department of Otolaryngology-Head and Neck Surgery, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA. matt.brigger@alumni.vanderbilt.edu
Brietzke
Scott E
SE
D000556:Ambulatory Surgical Procedures; D002648:Child; D002908:Chronic Disease; D006801:Humans; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery*; D016896:Treatment Outcome