Tonsillectomy in or out?
Reviewed by Badr Eldin Mostafa

Although tonsillectomy is the most common surgical act performed in ENT practice, there is still some concern about the safety of outpatient or day surgery scheduling, especially in adults. Although this has been common practice in many departments for some time, guidelines and regional regulations are still unclear. In this study the authors report that only about 12.9% of tonsillectomies were performed on an outpatient basis in France due to concerns on immediate complications. They thus conducted a year-long retrospective study on all tonsillectomies performed in their department. Out of a total of 179 cases, 108 were performed as outpatients (89 children and 19 adults). Patients selected for inpatient management included those with severe OSA, age <3, comorbidities, bleeding tendencies and logistic problems. They found no significant differences in the incidence of complications with significant benefits in terms of reduction in postoperative infections, speedier recovery in a familiar environment and a significant cost reduction in operational costs as well. The main recommendation for the proper establishment of such a system is the creation of a dedicated OR suite for tonsillectomies, proper cooperation of the surgeon with the anaesthetist with proper patient selection and significant efforts to reduce PONV and pain and good communication with the parents and caretakers.

Amygdalectomie chez l’enfant et l’adulte: evolution des pratiques apres ouverture d’une unite de chirurgie ambulatoire avec bloc operatoire dedie.
Bartier S, Gharzouli N, Kiblut H, et al.
ANN FRANC D’OTO-RHINO LARYNGOL PATH CEVIC-FAC
2018;135:295-300.