Granell Jose, Gete Pilar, Villafruela Miguel, Bolaños Caridad, Vicent Juan Jose Alvarez
Department of Otorhinolaryngology, 12 de Octubre Hospital, Madrid, Spain.
Otolaryngol Head Neck Surg. 2004 Oct;131(4):383-7. doi: 10.1016/j.otohns.2004.03.027.
We present our experience with outpatient tonsillectomy in children and critically review safety to support the outpatient policy.
We conducted a retrospective chart review from January 1995 through December 2000 in the pediatric otolaryngology unit of a tertiary care university hospital.
One thousand two hundred forty-three patients were accepted in the outpatient program with permissive criteria. Postoperative observation time ranged from 3 to 5 hours (median, 4.5 hours). The overall rate of complications was 9.3% (n = 116). Primary and secondary bleeding rates were 6.27% (n = 78) and 0.48% (n = 6), respectively. Thirty-six children (2.9%) had major bleeding; 2 of them were not identified in day-hospital (0.16%). Discharge was delayed in 103 patients (8.3%), and 13 patients showed complications after discharge (about 1% readmission rate).
Our program outcomes support safety. Outpatient surgery is meant to provide comfort to the patient and efficiency to the health care system, without impairing safety; in our experience, most tonsillectomies in children comply with these objectives.
Outpatient tonsillectomy in children may be safe even with permissive criteria, when an appropriate setting is available.
我们介绍儿童门诊扁桃体切除术的经验，并严格审查安全性以支持门诊政策。
我们对一所三级护理大学医院儿科耳鼻喉科1995年1月至2000年12月期间的病历进行了回顾性分析。
1243例患者符合宽松标准纳入门诊手术项目。术后观察时间为3至5小时（中位数为4.5小时）。总体并发症发生率为9.3%（n = 116）。原发性出血率和继发性出血率分别为6.27%（n = 78）和0.48%（n = 6）。36名儿童（2.9%）发生大出血；其中2例在日间医院未被发现（0.16%）。103例患者（8.3%）出院延迟，13例患者出院后出现并发症（再入院率约1%）。
我们的项目结果支持安全性。门诊手术旨在为患者提供舒适感并提高医疗系统的效率，同时不损害安全性；根据我们的经验，大多数儿童扁桃体切除术符合这些目标。
在具备适当条件时，即使采用宽松标准，儿童门诊扁桃体切除术也可能是安全的。
