title: Impact of the mode of hospitalisation on the postoperative complication rate after dissection tonsillectomy in children.
abstract: OBJECTIVE
  To compare postoperative complication rates after dissection tonsillectomy in patients operated by outpatient surgery and patients operated by inpatient surgery.
  
  
  METHODS
  A prospective, single-centre, observational study was conducted over a period of 1 year. Dissection tonsillectomy was performed in 103 patients (mean age: 4 years) between September 2011 and September 2012. The following parameters were studied: bleeding or inflammatory complication rate, readmissions, unscheduled visits, factors contraindicating outpatient surgery, reasons for failure of outpatient surgery and influence of Postoperative Nausea and Vomiting scores.
  
  
  RESULTS
  Two patient groups were composed: 54 patients were managed by outpatient surgery (Group O) and 49 patients were managed by inpatient surgery (Group I). The two main factors contraindicating outpatient surgery were age less than 3 years (40%) and preoperative suspicion of sleep apnoea-hypopnoea syndrome (26%). Seven patients of Group O had to stay in hospital (outpatient failure rate of 13%). Postoperative complications were observed in 13% of patients of Group O versus 12.2% of patients of Group I with no statistically significant difference between the two groups. One patient in each group had to be readmitted; no statistically significant difference was observed between the two groups (P=0.41). PONV scores were very high (2) in all cases.
  
  
  CONCLUSIONS
  Outpatient tonsillectomy in well-selected patients is not associated with a higher postoperative complication rate than inpatient tonsillectomy. With systematic appropriate prophylaxis, Postoperative Nausea and Vomiting scores had no influence on the postoperative course.
authors.affiliation: Service d'ORL et de chirurgie de la face et du cou, centre hospitalier Nord, place Victor-Pauchet, 80054 Amiens cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Ferary
authors.affiliation: Service d'ORL et de chirurgie de la face et du cou, centre hospitalier Nord, place Victor-Pauchet, 80054 Amiens cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Biet
authors.affiliation: Service d'ORL et de chirurgie de la face et du cou, centre hospitalier Nord, place Victor-Pauchet, 80054 Amiens cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Strunski
authors.affiliation: Service d'ORL et de chirurgie de la face et du cou, centre hospitalier Nord, place Victor-Pauchet, 80054 Amiens cedex, France. Electronic address: page.cyril@chu-amiens.fr.
authors.forename: C
authors.initials: C
authors.lastname: Page
mesh_terms: D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D010359:Patient Readmission; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D014068:Tonsillectomy
keywords: Outpatient surgery; Tonsillectomy