Clinical audit on tonsils and adenoid surgery. Is day surgery a reasonable option?

Four hundred and five patients who underwent tonsillectomy and/or adenoidectomy over a 27-month period were reviewed retrospectively to determine local patient characteristics and complication rates. The predominance of adult patients (mean age of 23.8 years), male subjects (male to female ratio of 2:1), and tonsillectomy cases (85.4%) were in contrast to studies reported in Western countries. Chronic tonsillitis or adenoiditis was the most common indication for surgery and the most frequent complications encountered were fever (20.0%) and haemorrhage (5.2%). Three patients (0.7%) had significant haemorrhage requiring a return to the operating theatre for haemostasis. Bleeding occurred within 6 hours in 2 patients and on the third postoperative day in 1 patient. The rate of haemorrhage was significantly higher in male patients (P = 0.038). The average duration of hospitalisation was 3.6 days. The main reasons for delayed discharge from hospital were retention for observation of pain and fever or for social or administrative purposes. Based on the results of the survey, day surgery for tonsillectomy and adenoidectomy would be feasible in Singapore provided patients are carefully selected and actively monitored for at least 6 hours after the operation.