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Assessment of sequelae at home following adenotonsillectomy. A basis for day-case management?
1Department of Otolaryngology, Royal Hospital for Sick Children, Bristol, UK.
Insights
Day-case adenotonsillectomy (tonsil and adenoid removal) is uncommon in the UK. Parental anxiety is high, with most preferring an overnight stay, indicating a need for better parental support for this surgical approach.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Health Services Research
Background:
- Adenotonsillectomy is a common pediatric surgical procedure.
- Traditionally performed as an inpatient procedure, day-case adenotonsillectomy is gaining traction internationally but remains rare in the UK.
- Parental acceptance and support are crucial for the successful implementation of day-case surgical models.
Purpose of the Study:
- To evaluate the feasibility and parental attitudes towards day-case adenotonsillectomy in a UK cohort.
- To identify barriers and facilitators for adopting day-case adenotonsillectomy in the UK.
- To assess parental concerns and preferences regarding inpatient versus day-case surgical settings for pediatric adenotonsillectomy.
Main Methods:
- Prospective cohort study of 100 children undergoing adenotonsillectomy.
- Post-discharge follow-up to monitor patient progress and recovery.
- Parental surveys to assess attitudes, anxieties, and preferences regarding day-case surgery.
Main Results:
- A significant majority of parents expressed anxiety regarding day-case adenotonsillectomy.
- Only 28% of parents preferred a day-case procedure, while 46% felt a single overnight stay was insufficient.
- Parental concerns highlight a need for enhanced support systems for day-case surgical models in the UK.
Conclusions:
- Day-case adenotonsillectomy is not widely accepted by UK parents due to significant anxiety.
- Increased parental education, support, and clear communication are necessary to improve acceptance of day-case adenotonsillectomy.
- Further research is needed to address parental concerns and optimize the implementation of day-case adenotonsillectomy in the UK.
Abstract:
Adenotonsillectomy is traditionally performed as an in-patient procedure. Although day-case adenotonsillectomy is practised in some units in the USA, Canada, Finland and Israel, it is rarely practised in the UK. This study looks at a cohort of 100 consecutive children admitted for adenotonsillectomy and follows their progress after discharge. It also assesses parental attitudes to day-case surgery. The results highlight parental anxiety associated with day-case adenotonsillectomy. Only 28% of parents would have liked the procedure to be carried out on a day-case basis with 46% of parents considering a single night stay to be too short. More support must be given to parents in the UK if day-case adenotonsillectomy is to become an acceptable procedure.