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Tonsillectomy 

Tonsillectomy is the surgical removal of the tonsils. Post-operative bleeding is the most common serious complication of the operation.

Data from a UK national audit1 showed that between 4 to 8 % of tonsillectomy patients experienced post-operation bleeding (defined as any bleeding that result in delayed hospital discharge, blood transfusion or return to operating theatre during the same stay or that required a readmission to the hospital within 28 days of the operation).

CGH data from January to December 2007 shows, the following information is gathered:

  • The majority of tonsillectomies are done as same day admissions, with a small number admitted one day before or as day surgeries.
  • Almost all (98%) tonsillectomy patients stayed either 1 or 2 days. The remaining 2% stayed for either 3 or 4 days, although this is due to reasons other than bleeding.
  • 3.8% of tonsillectomy patients were readmitted within 30 days of the operation due to bleeding. Of these, only one patient(0.6%) required a return to the operating theatre to stop the bleeding.
  • No patient required a blood transfusion.

In a study reported in The Journal of Laryngology and Otology2, the incidence of secondary tonsillectomy bleeding increases with age and the majority (69.8%) were encountered between the 4th and 7th day after the operation.

Hence, we advise patients to follow the pre and post-operative care instructions closely for a speedy and uneventful recovery.

(Source: ENT Department & Medical Information Management, CGH)

References

  1. Cromwell D. & van der Meulen J (2008), ‘Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit’, Quality and Safety in Healthcare, vol.17, pp. 264-268.
  2. Alexander RJ, Kukreja R & Ford GR (2004), ‘Secondary post-tonsillectomy haemorrhage and informed consent’, The Journal of Laryngology and Otology, vol. 118, no. 12, pp. 937-940.