Learning curve of tonsillectomy

Wei, Pei-Yin; Chu, Chin‐Chou; Wang, Mao-Che

doi:10.1016/j.anl.2017.07.004

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…This may probably shorten the tonsillectomy learning curve. [32][33][34] The use of a quality register to identify complication rates in hospitals is very useful. The patients reported complications toNTSR, and the complication rate was continuously updated in a database accessible to all participating doctors in the hospitals.…”

Section: Discussionmentioning

confidence: 99%

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Reducing post-tonsillectomy haemorrhage: a multicentre quality improvement programme incorporating video-based cold technique instruction

et al. 2022

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ObjectiveData from the Norwegian Tonsil Surgery Register (NTSR) showed large differences between the hospitals in Norway in the readmission rate due to post-tonsillectomy haemorrhage (rrPTH; range, 0%–25%; national average, 8%). Because of these large variations in the rrPTH, we conducted a quality improvement project involving hospitals with good and bad readmission rates.MethodsSeven hospitals with readmission rates greater than 10% and four with rates lower than 5% participated in this project. We recorded videos of ear, nose and throat surgeons from the hospitals with low readmission rates when they performed extracapsular tonsillectomy, and these videos of cold dissection tonsillectomy were used as teaching material for examples of good surgical skills for the other hospitals. After a 2-day workshop, all participants from the hospitals went back to their institutions and prepared local plans to improve their results. We used the Plan–Do–Study–Act model. The primary outcome variable was the patient-reported rrPTH in the NTSR. As secondary goal, we aimed to identify aspects of the tonsillectomy procedure that could help achieve a lower rrPTH.ResultsThe participating hospitals reduced their rrPTH from 18% at baseline (2017/2018) to 7% in 2020. Six of seven hospitals changed their dissection technique significantly to more use of cold dissection.ConclusionBy learning cold dissection tonsillectomy from surgeons with low rrPTH, it seems possible to decrease the rates of bleeding complications after tonsillectomy. A combination of videos as a teaching tool, new treatment plans, and focus on quality and improvement may effectively improve surgical results. The videos can show details that are difficult to convey in the literature. Quality registers can be used to identify areas requiring improvement and evaluate the effects of changes in practice.

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Section: Discussionmentioning

confidence: 99%

“…Newer surgeons can adopt these experience when they start with tonsillectomies, and they can always rewatch the videos and study details in the procedure. This may probably shorten the tonsillectomy learning curve 32–34. The use of a quality register to identify complication rates in hospitals is very useful.…”

Section: Discussionmentioning

confidence: 99%