Tonsillectomy in Australia: An audit of surgical technique and postoperative care

Abstract

Australian surgeons still use monopolar diathermy as their preferred technique for tonsillectomy. Local anesthetic, dexamethasone, and postoperative antibiotics are used infrequently, and fewer than 1:4 surgeons perform day-case tonsillectomy.

Overnight in-hospital observation following tonsillectomy: retrospective study of post-operative intervention

“…6 Most post-tonsillectomy haemorrhage occurs at days 5-7 post-tonsillectomy, when patients have already been discharged. [7][8][9][10] Identifying patients at highest risk for serious complications during the first 24 hours postoperatively would allow them to be excluded from day-case surgery.…”

“…disorders; and surgeon factors, such as diathermy use during the procedure. [8][9][10][11][12]14,15 Multiple studies advocating day-case tonsillectomy have proposed selection criteria based on individual institutional experiences and the lack of complications occurring as a result of their selection processes. However, there are no evidence-based guidelines recommending which patients are safe for day-case tonsillectomy.…”

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

“…Hot dissection is used in about 50% of tonsillectomies [20] in Great Britain, whereas in Australia 64% of tonsillectomies are performed using various types of "hot" techniques [47]. An investigation carried out in the USA in 2011 indicated the mono-polar cauterization as the most common technique for haemostasis in tonsillectomy [48].…”

Cold/cold vs. bipolar dissection tonsillectomy: A surgeon‐controlled study of 400 cases

“…The tonsillectomy procedure consists of 2 phases: tonsil excision and haemostasis, which can be classified as “hot” or “cold.”…”

“…1,2 The tonsillectomy procedure consists of 2 phases: tonsil excision and haemostasis, which can be classified as "hot" or "cold." 2,3 • Hot Excision: Bipolar diathermy involves high-frequency electric current being applied directly to the tonsil tissue from forceps.…”