Mehmet Eser Sancaktar1,2, Mehmet Çelebi3,4, Mahmut Yıldırım3,5, Erkan Can3,6, Gökhan Akgül3,7, İbrahim Ağrı3,8, Asude Ünal3,9, Fatih Yılmaz10,11. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsun Training and Research Hospital, University of Medical Sciences, Ministry of Health, Samsun, Turkey. eser_sancak@hotmail.com. 2. , Esenevler Mahallesi, Şehit Alaaddin Pergel Caddesi No: 52, A Blok No: 16, Atakum, Samsun, Turkey. eser_sancak@hotmail.com. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Samsun Training and Research Hospital, University of Medical Sciences, Ministry of Health, Samsun, Turkey. 4. , Mimar Sinan Mahallesi, 176, Sokak, 1, Blok No: 12, Atakum, Samsun, Turkey. 5. , Mimar Sinan Mahallesi, 176, Sokak, 6-A/23, Atakum, Samsun, Turkey. 6. , Esenevler Mahallesi, Şehit Alaaddin Pergel Caddesi No: 52, C Blok No: 25, Atakum, Samsun, Turkey. 7. , Fevzi Çakmak Mahallesi, Altınyunus Sokak, B 22, İlkadım, Samsun, Turkey. 8. , Cumhuriyet Mahallesi, 70, Sokak, No: 10, Atakum, Samsun, Turkey. 9. , Denizevleri Mahallesi, Atatürk Bulvarı, B Blok, 118/6, Atakum, Samsun, Turkey. 10. Department of Otorhinolaryngology-Head and Neck Surgery, Bozyaka Training and Research Hospital, University of Medical Sciences, Ministry of Health, Izmir, Turkey. 11. , Örnekköy mahallesi, 7600 Sokak, A Blok, No: 82, Karşıyaka, Izmir, Turkey.
Abstract
PURPOSE: To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients. METHODS: The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded. RESULTS: A total of 276 patients met the inclusion criteria, comprising 139 (50.4%) females and 137 (49.6%) males with a mean age of 27.17 ± 9.41 years. The most common indication was recurrent tonsillitis (n = 223, 80.8%), and surgical techniques used were bipolar scissors (CURIS®, Sutter Medizintechnik, Germany) (n = 137, 49.6%), cold dissection (n = 75, 27.2%) and/or plasma blade (PEAK Surgical, Medtronic, USA) (n = 64, 23.2%). A total of 43 (15.5%) re-admissions from 37 (13.4%) patients were recorded because of bleeding (n = 33, 70.2%) and/or odynodysphagia (n = 13, 27.7%). Non-surgical interventions were sufficient in 32 (74.4%) cases, while surgical interventions were required in 11 (25.6%) patients. In patients where "hot" techniques (bipolar scissors, plasma blade) were used and in patients with complaints in the first 24 h postoperatively, significantly increased rates of elongated LOS values for more than 1 day were determined (p < 0.01, p < 0.001). CONCLUSIONS: Adult tonsillectomy is a safe surgical procedure with low complication, re-operation and mortality rates. Significantly increased rates of elongated LOS values for more than 1 day and re-admissions after discharge were determined in those patients having complications in the first 24 h postoperatively. Cold dissection seems to be more advisable than hot techniques for outpatient tonsillectomy among adult patients.
PURPOSE: To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients. METHODS: The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded. RESULTS: A total of 276 patients met the inclusion criteria, comprising 139 (50.4%) females and 137 (49.6%) males with a mean age of 27.17 ± 9.41 years. The most common indication was recurrent tonsillitis (n = 223, 80.8%), and surgical techniques used were bipolar scissors (CURIS®, Sutter Medizintechnik, Germany) (n = 137, 49.6%), cold dissection (n = 75, 27.2%) and/or plasma blade (PEAK Surgical, Medtronic, USA) (n = 64, 23.2%). A total of 43 (15.5%) re-admissions from 37 (13.4%) patients were recorded because of bleeding (n = 33, 70.2%) and/or odynodysphagia (n = 13, 27.7%). Non-surgical interventions were sufficient in 32 (74.4%) cases, while surgical interventions were required in 11 (25.6%) patients. In patients where "hot" techniques (bipolar scissors, plasma blade) were used and in patients with complaints in the first 24 h postoperatively, significantly increased rates of elongated LOS values for more than 1 day were determined (p < 0.01, p < 0.001). CONCLUSIONS: Adult tonsillectomy is a safe surgical procedure with low complication, re-operation and mortality rates. Significantly increased rates of elongated LOS values for more than 1 day and re-admissions after discharge were determined in those patients having complications in the first 24 h postoperatively. Cold dissection seems to be more advisable than hot techniques for outpatient tonsillectomy among adult patients.