Does the level of surgical training influence tonsillectomy outcomes? A prospective randomised study

Tonsillectomy is a common paediatric procedure with potential morbidity, notably post-operative pain and bleeding. One proposed factor influencing these outcomes is the surgeon's level of training.

To evaluate whether surgical training level affects short-term outcomes in paediatric tonsillectomy.

In a prospective randomised study (2019-2022), outcomes were compared in children undergoing cold dissection tonsillectomy performed by either an attending or a supervised resident. Measured outcomes included duration of analgesia use, time to resume oral intake, length of hospital stay and post-operative bleeding.

A total of 115 children were included in the study, of which 60 (52.2 per cent) were operated on by residents and 55 (47.8 per cent) were operated on by attending surgeons. Baseline characteristics were similar. Operations by attending surgeons were shorter (20.4 vs 29.1 minutes), but no significant differences were found in post-operative pain, diet resumption, length of stay (1.1 days) or bleeding.

Supervised residents achieve comparable outcomes to attending surgeons. Surgical training level does not impact tonsillectomy outcomes under supervision.