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Post-tonsillectomy dietary advice and haemorrhage risk: Systematic review
Miles Bannister1, Chris Thompson1
1Department of Paediatric Otolaryngology, Royal Hospital for Sick Children Edinburgh, 9 Sciennes Road, Edinburgh, EH9 1LF, United Kingdom.
Insights
Post-tonsillectomy diet does not impact bleeding rates in children. This systematic review found no significant difference in post-tonsillectomy haemorrhage (PTH) rates between restricted and unrestricted diets, suggesting current advice can remain unchanged.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Evidence-Based Medicine
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Post-operative dietary recommendations after tonsillectomy vary among clinicians.
- The potential impact of diet on post-tonsillectomy hemorrhage (PTH) rates is not well-established.
Purpose of the Study:
- To systematically review the literature on post-operative diets following pediatric tonsillectomy.
- To assess the association between different dietary approaches and PTH rates.
- To provide evidence to guide clinical practice and future guideline development.
Main Methods:
- Systematic review of English literature from PubMed, Medline, and Cochrane databases.
- Search terms included 'post-tonsillectomy', 'diet', 'bleeding', 'haemorrhage', 'paediatric', and 'children'.
- Included studies comprised randomized controlled trials, case-control studies, and cohort studies.
Main Results:
- Eight publications involving 1039 patients were analyzed.
- Patients on restricted diets (n=545) had a 2.3% PTH rate.
- Patients on unrestricted diets (n=494) had a 0.8% PTH rate, with no statistically significant difference (p=0.12).
Conclusions:
- Post-operative diet does not appear to influence post-tonsillectomy hemorrhage rates in children.
- Current dietary advice following pediatric tonsillectomy surgery should not be altered.
- Evidence does not support a change in clinical practice regarding post-tonsillectomy diet.
Objectives:
Tonsillectomy remains one of the commonest operations performed in children. Post-operative diet may affect post-tonsillectomy haemorrhage rate, although post-operative dietary advice varies. We undertook a systematic review of the published literature to assess if and how different post-operative diets were associated with differences in PTH rates following paediatric tonsillectomy, to provide an evidence base to inform individual otorhinolaryngologists' practice and for future guideline development.
Methods:
A systematic review of the published English literature of the PubMed, Medline and Cochrane Collaboration databases, using search terms used included 'post-tonsillectomy', 'diet', 'dietary advice', 'bleeding', 'haemorrhage', 'paediatric' &'children'.
Results:
Eight publications were included in the review, including 5 randomised controlled trials, 2 case-control studies and 1 cohort study. These involved 1039 patients with 545 patients following a restricted/non-additive diet after tonsillectomy and 494 patients following an unrestricted/additive diet. The average reported PTH rate of patients in the restricted diet groups was 2.3% and 0.8% in patients in the unrestricted diet groups, which is not statistically significant (p = 0.12, one tailed t-test).
Conclusion:
PTH following paediatric surgery does not appear to be affected by different post-operative diets or regimes followed by patients. Clinicians should not change the advice provided regarding oral intake and diet following tonsillectomy surgery in children.
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