The Sluder method in the Netherlands and the incidence of postoperative haemorrhage in a pediatric hospital.
OBJECTIVE
Analysis of the method of tonsillectomy in use in the Netherlands and the incidence of postoperative haemorrhage in an academic tertiary pediatric referral hospital.


METHODS
(A) An explorative study of the Sluder tonsillectomy method in the Netherlands and (B) a retrospective case file review at the Sophia Children's Hospital in Rotterdam.


METHODS
(A) A telephone and e-mail survey amongst 107 hospitals in the Netherlands. (B) A review of patients younger than 16 years who underwent a tonsillectomy or adenotonsillectomy between January 1, 1998, and February 22, 2008. This part of the study surveyed the intubated Sluder method and analyzed the incidence of primary and secondary haemorrhage in an academic tertiary pediatric referral hospital.


RESULTS
(A) The Sluder method was commonly used in 102 (95.32%) hospitals; the traditional dissection technique was exclusively used only in five hospitals (4.67%). Of the 102 hospitals using the Sluder method, 67 (65.68%) report using only inhalation mask anaesthesia, while the remaining 35 use intubation. (B) Of 1797 patients studied, 40 patients experienced postoperative tonsillar haemorrhage (2.23%), with 35 (1.95%) patients primary haemorrhage of which 32 (1.78%) within 6 h after the surgery. Secondary haemorrhage occurred in five (0.28%) patients.


CONCLUSIONS
The Sluder method is still generally used in the majority of hospitals in the Netherlands today. Because of the low incidence of especially secondary haemorrhage and most of the primary haemorrhages occurring within 6h after the surgery, this technique is ideally suited for day care tonsillectomy.
Tjon Pian Gi
R
R
Department of Pediatric Otorhinolaryngology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands.
Bliek
V
V
Borgstein
J
J
D000233:Adenoidectomy / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010036:Otolaryngology / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000706:statistics & numerical data