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Day-case tonsillectomy in children: parental attitudes and consultation rates
Mervi Kanerva1, Pekka Tarkkila, Anne Pitkäranta
1Department of Otorhinolaryngology, University Hospital of Helsinki, POB 220, FIN-00029, Hus, Finland. mervi.kanerva@hus.fi
Insights
Most parents found pediatric day-case tonsillectomy suitable, with low consultation rates post-surgery. This approach offers a viable alternative to traditional inpatient care for children undergoing tonsillectomy or adenotonsillectomy.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Health Services Research
Background:
- The rate of pediatric day-case tonsillectomy is increasing in Europe.
- Concerns exist regarding parental willingness and the burden of post-discharge care.
- This study addresses parental attitudes and post-operative consultation rates for day-case tonsillectomy.
Purpose of the Study:
- To introduce pediatric day-case tonsillectomy in a hospital setting.
- To assess parental attitudes towards same-day discharge after tonsillectomy.
- To evaluate consultation rates within two weeks of surgery.
Main Methods:
- Prospective study of 100 children (aged 3-16) undergoing day-case tonsillectomy or adenotonsillectomy.
- Recording of peri-operative and post-operative complications.
- Parental phone interviews conducted the day after surgery and 1-4 months later to gather opinions and consultation data.
Main Results:
- 90% of children were discharged on the same day; vomiting was the most common complication.
- 100% of parents initially felt same-day discharge was better than hospital stay, with 94.5% maintaining this view long-term.
- 13% of patients visited a physician and 17% called for information within two weeks, with low rates excluding secondary hemorrhage.
Conclusions:
- Pediatric day-case tonsillectomy is perceived as suitable by most parents.
- Consultation rates post-discharge were low, indicating successful implementation.
- Careful patient selection and comprehensive pre-operative information are crucial for successful day-case tonsillectomy.
Objective:
In Europe, the day-case tonsillectomy rate in children is slowly increasing, but whether parents really want this rapid discharge of their child is questionable. The fear is that aftercare might fall solely on community care. The aim of this prospective study was to introduce pediatric day-case tonsillectomy to our hospital and to determine parents' attitudes to this procedure. The other interest centered on consultation rates within the 2-week recovery period.
Methods:
One hundred children aged 3-16 years had day-case tonsillectomy (38) or adenotonsillectomy (62). Peri-operative and post-operative complications were recorded. Parents were phoned the next day and 1-4 months after the operation. Parents' opinions of day-case surgery and consultations with healthcare professionals during the 2-week recovery period were recorded.
Results:
Ninety children went home the day of the operation. Vomiting was the most frequent complication. No primary hemorrhages occurred. Called the next day, 100% of parents felt that their children were better served spending their first night at home as compared with staying in hospital. Called 1-4 months later, 94.5% of parents still thought this way. In the 2-week recovery period following the tonsillectomy, 13% of patients visited a physician and 17% called for information. These numbers include patients with secondary hemorrhage. If these are excluded, 5% of patients visited a physician and 13% called for advice. Children were taken back to hospital only due to secondary hemorrhage.
Conclusions:
Most parents considered day-case tonsillectomy to be suitable for their family. Consultation rates were low. Careful patient selection and adequate pre-operative information are prerequisites for day-case tonsillectomy.