Our Summary

This study looked at how often children had to return to the emergency department or be readmitted to the hospital after having their tonsils removed by a specific method called coblation tonsillectomy. This surgery was performed on children who had issues with their sleep due to breathing troubles or repeated tonsil infections.

The study included 2045 children and found that about 6% of them had to return to the hospital unexpectedly after their surgery. Of these, about 5% returned once, less than 1% returned twice, and a very small percentage returned three times.

The average time it took for the first and second return visits was roughly a week and a half. The reasons for these visits ranged from bleeding and fever to pain, nausea, vomiting, and dehydration. It was also found that children aged 1-3 years and those who lost more blood during surgery were more likely to return to the hospital.

However, most of these return visits were managed well and only 4 of them required another surgery.

The study concluded that the rate of return visits and the reasons for these visits after a coblation tonsillectomy were similar to those of other surgical methods. Therefore, this method of tonsil removal is considered safe and effective for children.

FAQs

  1. What is the rate of emergency department revisits and hospital readmissions following coblation tonsillectomy in children?
  2. What were the main reasons for revisits after coblation tonsillectomy in children?
  3. Is coblation tonsillectomy a safe and effective surgery for children?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about tonsillectomy is to closely follow post-operative care instructions provided by the healthcare team. This may include taking prescribed pain medication, staying hydrated, eating soft foods, and avoiding strenuous activities. Additionally, it is important to contact your healthcare provider if you experience severe pain, bleeding, or difficulty breathing after the procedure. By following these guidelines, patients can help ensure a smooth recovery process and minimize the risk of complications that may require a visit to the emergency department or hospital readmission.

Suitable For

Patients who are typically recommended for tonsillectomy include:

  1. Children with sleep-disordered breathing (SDB): Tonsillectomy is often recommended for children with SDB, such as obstructive sleep apnea, to improve breathing during sleep and reduce symptoms of sleep disturbances.

  2. Children with recurrent tonsillitis: Tonsillectomy may be recommended for children who experience frequent episodes of tonsillitis, as removing the tonsils can help reduce the frequency and severity of throat infections.

  3. Children with severe tonsil hypertrophy: Tonsillectomy may be recommended for children with significantly enlarged tonsils that are causing breathing difficulties, swallowing problems, or other related issues.

  4. Children with complications from tonsillitis: In some cases, children may develop complications from recurrent tonsillitis, such as abscess formation or difficulty breathing, which may necessitate tonsillectomy for treatment.

Overall, tonsillectomy is a common surgical procedure performed in children to address various medical conditions related to the tonsils and improve overall health and quality of life.

Timeline

Before tonsillectomy:

  1. Consultation with an ENT specialist to discuss the reasons for surgery (such as sleep-disordered breathing or recurrent tonsillitis).
  2. Pre-operative testing and evaluation to ensure the patient is healthy enough for surgery.
  3. Anesthesia consultation to discuss the anesthesia plan for the surgery.

After tonsillectomy:

  1. Recovery period in the hospital or outpatient setting immediately after surgery.
  2. Pain management and monitoring for complications such as bleeding or infection.
  3. Follow-up appointments with the surgeon to monitor healing and recovery.
  4. Potential revisit to the emergency department or readmission to the hospital for post-operative complications such as hemorrhage, fever, pain, nausea/vomiting, or dehydration.
  5. Most revisits are controlled well, with only a small percentage of cases requiring re-surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tonsillectomy may include:

  1. What are the potential risks and complications associated with tonsillectomy?
  2. How long is the recovery period after tonsillectomy?
  3. What can I expect in terms of pain and discomfort after the surgery?
  4. Will I need to take time off from work or school after the procedure?
  5. Are there any dietary restrictions or special precautions I should take during the recovery period?
  6. How will my sleep be affected after the surgery, especially if I had the procedure to address sleep-disordered breathing?
  7. What symptoms should I watch out for that may indicate a need for a revisit to the emergency department or readmission to the hospital?
  8. How will my follow-up care be managed after the surgery?
  9. Are there any long-term effects or considerations I should be aware of after having a tonsillectomy?
  10. What are the success rates of coblation tonsillectomy in children with sleep-disordered breathing or recurrent tonsillitis?

Reference

Authors: He Y, Cai Z, Yang J. Journal: Int J Pediatr Otorhinolaryngol. 2019 Jul;122:130-132. doi: 10.1016/j.ijporl.2019.04.013. Epub 2019 Apr 16. PMID: 31009921