• Jose Granell, Pilar Gete, Miguel Villafruela, Caridad Bolaños, and Juan Jose Alvarez Vicent.
• Department of Otorhinolaryngology, 12 de Octubre Hospital, Madrid, Spain. jgranelln@seorl.net
• Otolaryngol Head Neck Surg. 2004 Oct 1; 131 (4): 383-7.

ObjectiveWe present our experience with outpatient tonsillectomy in children and critically review safety to support the outpatient policy.Study Design And SettingWe conducted a retrospective chart review from January 1995 through December 2000 in the pediatric otolaryngology unit of a tertiary care university hospital.ResultsOne thousand two hundred forty-three patients were accepted in the outpatient program with permissive criteria. Postoperative observation time ranged from 3 to 5 hours (median, 4.5 hours). The overall rate of complications was 9.3% (n = 116). Primary and secondary bleeding rates were 6.27% (n = 78) and 0.48% (n = 6), respectively. Thirty-six children (2.9%) had major bleeding; 2 of them were not identified in day-hospital (0.16%). Discharge was delayed in 103 patients (8.3%), and 13 patients showed complications after discharge (about 1% readmission rate).ConclusionOur program outcomes support safety. Outpatient surgery is meant to provide comfort to the patient and efficiency to the health care system, without impairing safety; in our experience, most tonsillectomies in children comply with these objectives.SignificanceOutpatient tonsillectomy in children may be safe even with permissive criteria, when an appropriate setting is available.

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