The starship children's hospital tonsillectomy: A further 10 years of experience.
Tonsillectomy as a day-stay procedure remains controversial, although it is an established procedure in New Zealand. We reviewed our last 10 years' experience.



A prospective audit was used to determine unplanned conversion from day-stay to overnight hospital admission rates and the incidence of postoperative complications.



There were 5,400 tonsillectomies performed over the 10-year study period (January 2004-January 2015); 71% as outpatients. The unplanned conversion rate to overnight stay was 0.4%. The median age of day-stay patients was 6.5 years (range 13 months-15 years) compared with those admitted for overnight stay (5 years; range 8 months-15 years). The primary postoperative bleed rate was 0.5% (confidence interval [CI] 0.3%-0.7%), and the combined primary and secondary posttonsillectomy bleed rate was 4.3% (CI 3.8%-5.0%). The rate of patients returning with postoperative complications within 1 month of surgery was 6.3% (CI 5.6%-7.0%).



Day-stay tonsillectomy in the pediatric population is safe when performed using the described guidelines in a facility with appropriate resources.



4. Laryngoscope, 126:E416-E420, 2016.
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Murali
M
Mahadevan
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Graeme
G
van der Meer
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Maayan
M
Gruber
Children's Research Centre, Auckland District Health Board, Grafton, Auckland, New Zealand.
Peter
P
Reed
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Conor
C
Jackson
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Colin
C
Brown
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Nikki
N
Mills
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Lesley J
LJ
Salkeld
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Michel
M
Neeff
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Jan
J
Evans
Department of Anaesthesiology, University of Auckland, Grafton, Auckland, New Zealand.
Brian
B
Anderson
Department of Paediatric Otolaryngology, Starship Children's Hospital, Grafton, Auckland, New Zealand.
Colin
C
Barber
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D002648:Child; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007902:Length of Stay; D009520:New Zealand; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods
Tonsillectomy; day stay surgery; hemorrhage