[Postoperative bleeding after tonsillectomy between 1985 and 2001 and experiences to perform laser tonsillotomy]

Abstract

Background: Tonsillectomy is one of the most often performed surgery in our specialty. But postoperative bleeding is not only a statistic risk, it can lead to a tragic end individually. In the future and according to the DRGs, a postoperative stay in hospital for more than 6 days will be difficult to realise.

Methods: 10 052 patients after tonsillectomy were measured, 7663 were performed in the ORL-Department of Würzburg, 2389 in the ORL-Department of Augsburg. Further data was measured by questioning the parents of 65 young children after lasertonsillotomy.

Patients: The patient group of the tonsillectomies included all ages, the group of the lasertonsillotomies included young children aged 1- 6 years.

Results: The first spike of bleedings of the ORL-Department in Würzburg was found within the first 24 hours after surgery. A second spike showed between the 5 (th) and 7 (th) postoperative day, an other after the 8 (th) and 15 (th) postoperative day. In the ORL-Department Augsburg the main spike was found from the 7 (th) until the 9 (th) postoperative day. No postoperative bleedings were found in the lasertonsillotomies.

Conclusions: A postoperative stay in hospital is sufficient for 3 days, but should vary individually. On young children with symptomatic hyperplasia of the tonsils a lasertonsillotomy should be performed.