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Day case adenotonsiletomy: experience of two private clinics in Nigeria
A S Adoga1, P A Onakoya, N C Mgbor
1Department of Otorhinolaryngology, College of Medicine of University of Nigeria, Nsukka.
Insights
Day-case adenoidectomy and tonsillectomy are safe pediatric procedures with low complication rates. Family presence significantly aids post-operative recovery in children undergoing these common ear, nose, and throat surgeries.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Ambulatory Surgery
Background:
- Adenoidectomy and tonsillectomy are frequent pediatric surgeries.
- Evaluating post-operative mobility in day-case procedures is crucial.
Purpose of the Study:
- To assess the safety and outcomes of day-case adenoidectomy, tonsillectomy, or adenotonsillectomy in children.
- To identify complication rates and factors influencing recovery.
Main Methods:
- Retrospective analysis of pediatric patients undergoing adenoidectomy/tonsillectomy at two clinics (1990-2004).
- Inclusion criteria focused on patients fit for general anesthesia (ASA I/II) without bleeding diathesis.
- Counseling for day-case surgery was provided to eligible patients.
Main Results:
- Sixty-six out of 144 patients (45.8%) met inclusion criteria for day-case surgery.
- Adenoidectomy comprised 47% of procedures, with most patients under 7 years old.
- Low complication rates observed: reactionary hemorrhage (4.5%), vomiting (19.7%), fever (7.6%), and pain (34.8%); no fatalities.
Conclusions:
- Day-case adenoidectomy/tonsillectomy/adenotonsillectomy is a safe procedure in pediatric patients.
- Low complication rates support the viability of same-day discharge.
- Family support positively impacts patient recovery, providing a calming effect.
Background:
adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy.
Methodology:
All pediatrics cases requiring adenoidectomy, tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery-ASA grade I or II for general anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others.
Results:
A total number of 144 patients requiring adenoidectomy Tonsillectomy or both were seen at the study centers with only sixty six (45.8%) meeting the inclusion criteria. Adenoidectomy constituted 47% of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5%) of the patient, the other complications were non-persistent vomiting 13 (19.7%), low grade fever 5 (7.6%) and pain at time of discharge 23 (34.8%). There were no fatalities.
Conclusion:
The complication rates were low. Day-case Adenoidectomy/tonsillectomy or adenotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/post recovery as this as this had a soothing/calming effect on the patient/s.
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