Paediatric Surgery

Post-Tonsillectomy and Post-Adenoidectomy Hemorrhage in Children

Tonsillectomy (removal of the tonsils) and adenoidectomy (removal of the lymphoid tissue in the back of the nose) are two of the most common surgeries performed in KK Women’s and Children’s Hospital Pediatric Otolaryngology Department. Both are relatively simple surgical procedures conducted under general anesthesia. However, complications of post-operative bleeding, either within 24 hours of surgery, or up to 14 days post-surgery can occur.

A 5-year Clinical Audit of tonsillectomy (with or without adenoidectomy) was conducted from 2017 to 2021 to establish the rate of post-operative hemostasis. The audit revealed a total of 1,963 tonsillectomy cases with or without adenoidectomy. There were 34 cases that required return to operating theatre for hemostasis, giving a postoperative hemostasis rate of 1.7%.

Our post-adenotonsillectomy hemostasis rate of 1.7% is comparable to the rates quoted in the literature which range from 1.3% to 5.65%.

References

1. Lee Walter T, Witsell D, Schulz K. Tonsillectomy bleed rates across CHEERS Practice Research Network: Pursuing Guideline Adherence and Quality Improvement. Otolaryngology Head Neck Surg. 2016 Jul; 155(1): 28-32.
2. Alvo A, Hall A, Johnston J, Mahadevan M. Pediatric Posttonsillectomy Hemorrhage Rates in Auckland: A Retrospective Case Series. International Journal of Otolaryngology. 2019.
3. Susaman N, Kaygusuz I, Karlidag T et al. Risk Factors for Post-tonsillectomy Hemorrhage. ENT Updates 2018;8(2): 114-119.