Filip Lundström1,2, Joacim Stalfors3,4, Eirik Østvoll3, Ola Sunnergren5,2. 1. Department of Otorhinolaryngology, Linköping University Hospital, Linköping, Sweden. 2. Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. 3. Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden. 4. Sheikh Khalifa Medical City, Ajman, United Arab Emirates. 5. Department of Otorhinolaryngology, Region Jönköping County, Jönköping, Sweden.
Abstract
Background: To assure a high quality in tonsil surgery, it is necessary to monitor trends in clinical practice, complications and outcome.Aims/objectives: To describe rates and trends regarding indications, methods, techniques, complications, and outcome of tonsil surgery.Material and method: 98 979 surgeries from the National Tonsil Surgery Register 2009-2018. Groups were categorised by indication and method. Results: The proportion of patients undergoing tonsillotomy with adenoidectomy due to obstruction-snoring (mean age 5.3 y.) increased from 2009-2018. Hot tonsillectomy, but not tonsillotomy, techniques were related to a higher risk for postoperative bleeding. The use of cold techniques increased for all types of surgeries. The rates of patients reporting contact due to postoperative pain were associated with indication and method, with the lowest rate reported for tonsillotomy (4.5% in 2018) and the highest for tonsillectomy (34.5% in 2009). The rate of patients reporting that their symptoms were gone 6 months after surgery decreased.Conclusions and significance: All hot tonsillectomy techniques should be avoided as they are related to a higher risk for postoperative bleeding. The high rate of postoperative contacts due to pain after tonsillectomy indicates a need for improvement in pain management. The declining rates of symptom relief must be investigated further.
Background: To assure a high quality in tonsil surgery, it is necessary to monitor trends in clinical practice, complications and outcome.Aims/objectives: To describe rates and trends regarding indications, methods, techniques, complications, and outcome of tonsil surgery.Material and method: 98 979 surgeries from the National Tonsil Surgery Register 2009-2018. Groups were categorised by indication and method. Results: The proportion of patients undergoing tonsillotomy with adenoidectomy due to obstruction-snoring (mean age 5.3 y.) increased from 2009-2018. Hot tonsillectomy, but not tonsillotomy, techniques were related to a higher risk for postoperative bleeding. The use of cold techniques increased for all types of surgeries. The rates of patients reporting contact due to postoperative pain were associated with indication and method, with the lowest rate reported for tonsillotomy (4.5% in 2018) and the highest for tonsillectomy (34.5% in 2009). The rate of patients reporting that their symptoms were gone 6 months after surgery decreased.Conclusions and significance: All hot tonsillectomy techniques should be avoided as they are related to a higher risk for postoperative bleeding. The high rate of postoperative contacts due to pain after tonsillectomy indicates a need for improvement in pain management. The declining rates of symptom relief must be investigated further.
Entities:
Keywords:
Tonsillectomy; healthcare quality improvement; post-tonsillectomy haemorrhage; postoperative complications; quality of health care; tonsillotomy
Authors: Filip Lundström; Erik Odhagen; Fredrik Alm; Claes Hemlin; Pia Nerfeldt; Ola Sunnergren Journal: BMC Med Res Methodol Date: 2022-01-07 Impact factor: 4.615
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