Outcomes of reduced postoperative stay following outpatient pediatric tonsillectomy.

OBJECTIVE To assess outcomes of reduced postoperative recovery room observation times and associated complication rates following outpatient pediatric adenotonsillectomy at a tertiary care medical center outpatient facility over a 7.5-year period. STUDY DESIGN Retrospective chart review. METHODS Charts from all outpatient pediatric adenotonsillectomies performed by one surgeon from January 1998 through June 2005 at a tertiary care center were reviewed. RESULTS Seven hundred and ninety seven (797) charts had sufficient documentation to be included in this study. Mean patient age was 6.8 years (median 5.5 years, range 2-21 years). There were 53 patients under 3 years old (6.64%), 655 patients age 3-12 years (82.18%), and 89 patients age 12-21 years (11.17%). Mean postoperative recovery room observation time prior to discharge was 1.47 h (median 1.33 h, range 0.45-7.25 h). Primary (<24 h postoperative) complication rate was 0.0075%, and secondary (>24 h postoperative) complication rate was 0.0063%. There were no significant differences in duration of postoperative recovery room observation or postoperative complications between the three age groups (p=0.10). CONCLUSIONS Very brief postoperative observation periods following outpatient pediatric adenotonsillectomy may be considered safe, without added risk nor increased short-term or long-term complications. While individual cases may merit prolonged postoperative observation periods, the majority of study patients had no postoperative complications despite shorter recovery room stays than described in prior reports. These data support safety and efficacy of reduced postoperative stays. Our data should be considered in order to increase the efficiency and cost effectiveness of outpatient surgery centers where such procedures are performed.