Otolaryngology - Post-Tonsillectomy and Post-Adenoidectomy Hemorrhage in Children

Tonsillectomy (removal of the tonsils) and adenoidectomy (removal of the lymphoid tissue in the back of the nose) are two of the most common surgeries performed in KK Women’s and Children’s Hospital Pediatric Otolaryngology Department. Both are relatively simple surgical procedures conducted under general anesthesia. However, complications of post-operative bleeding, either within 24 hours of surgery, or up to 14 days post-surgery can occur.

A 5-year Clinical Audit of tonsillectomy (with or without adenoidectomy) was conducted from 2020 to 2024 to establish the rate of post-operative hemostasis. The audit revealed a total of 1,789 tonsillectomy cases with or without adenoidectomy. There were 11 cases that required return to operating theatre for hemostasis, giving a postoperative hemostasis rate of 0.61%.

Conclusion

Our post-adenotonsillectomy hemostasis rate of 0.61% is lower compared to rates quoted in the literature which range from 1.3% to 5.65%.

References:

• Lee Walter T, Witsell D, Schulz K. Tonsillectomy bleed rates across CHEERS Practice Research Network: Pursuing Guideline Adherence and Quality Improvement. Otolaryngology Head Neck Surg. 2016 Jul; 155(1): 28-32.
• Alvo A, Hall A, Johnston J, Mahadevan M. Pediatric Posttonsillectomy Hemorrhage Rates in Auckland: A Retrospective Case Series. International Journal of Otolaryngology. 2019.
• Susaman N, Kaygusuz I, Karlidag T et al. Risk Factors for Post-tonsillectomy Hemorrhage. ENT Updates 2018;8(2): 114-119.

• Clinical Outcomes
• KK Gynaecological Cancer Centre
• KKIVF Centre
• Obstetrics
• Eclampsia Rates
• KK Urogynaecology Centre
• Complication Rate after Dermatological Procedure
• Rates of Respiratory Adverse Events during Procedural Sedation
• Glycaemic control in children and young people with type 1 diabetes
• Paediatric Gastrointestinal Endoscopy Clinical Outcomes
• Transplant & Leukemia Survival Rates
• International Clinical Outcomes for Neonatals
• Systemic Lupus Erythematosus Outcome - 5 and 10 year survival rates of patients with Lupus Nephritis
• Post-Tonsillectomy and post-adenoidectomy Hemorrhage in Children
• Negative Appendectomy vs Preoperative CT Scan
• Complicated Appendicitis Complication Rates
• Scoliosis Neurological Deficit and Death Rates
• Diagnostic and Interventional Imaging
• Success Rate of Air Enema Reduction under Fluoroscopy Guidance
• Women’s Anaesthesia
• Percentage of Patients with Failed Regional Anaesthesia for Obstetric and Gynaecological Operations
• Carbapenem Appropriateness