Adenotonsillectomy day-case discharge criteria: a systematic review
Reviewed by Dimitrios Spinos

In this paper, Gowda et al review the literature aiming to answer a long-standing question regarding the criteria for same-day discharge of paediatric patients post adenoidectomy and/or tonsillectomy performed for treatment of obstructive sleep apnoea (OSA). Following PRISMA consensus, they conducted a systematic review using EMBASE, Medline and Cochrane libraries. Amongst the 15 studies included in the review, there was a notable variance in planned day-case procedures with some authors reporting as high as 100%, while the lower end was just shy of 30%. The rate of discharge amongst the planned day cases was 96.1%, with the rate of postoperative adverse respiratory events varying from 0% to 27.3%. Overall, a further intervention was required in less than 10% of the patients. It is widely accepted that day cases should be considered, when appropriate, as a measure to tackle the waiting lists and surgical backlog created during the pandemic. Unfortunately, the authors highlight the lack of prospective data on patient outcomes and review of discharge criteria. The heterogeneity of the selection and perioperative respiratory distress rates further emphasise the need for more robust, widely accepted criteria on discharging paediatric patients with OSA.

Day-case discharge criteria and safety of children undergoing adenoidectomy and tonsillectomy for obstructive symptoms—A systematic review.
Gowda S, Leong W, Edafe O.
CLIN OTOLARYNGOL
2022;47(5):553-60.