Remembering the Importance of an Old Friend: History Taking in Preoperative Evaluation of Healthy Children: A Single Center Experience

Objective: To investigate the consequences of routine laboratory tests that lead to surgical delay or high cost in patients with a normal medical history and physical examination who undergo minor surgical interventions. Patients and Method: Files of 1,322 patients aged between 0-16 years that had undergone elective surgical intervention within six years were reviewed. Results: Of the 1,322 patients, 1,246 (94.3%) had normal physical examination and laboratory findings. Seventy-six children who had abnormalities in laboratory findings and physical examination were referred to pediatrics. Of the 76 pediatric referees, 42 (55.3%) were reevaluated and were diagnosed with upper respiratory tract infection ( n =23; 30.2%), iron deficiency anemia ( n =5; 6.5%), innocent murmur ( n =4; 5.3%), thalassemia minor ( n =2; 2.6%), lower respiratory tract infection ( n =2; 2.6%), urinary tract infection ( n =1; 1.3%), mumps ( n =1; 1.3%), acute gastroenteritis ( n =1; 1.3%), minimal aortic and tricuspid valve insufficiency ( n =1; 1.3%), minimal aortic stenosis ( n =1; 1.3%), atrial septal defect ( n =1; 1.3%). Surgical interventions were delayed until the recovery of the infectious diseases. In 25 of the patients, repeated tests showed normal ranges after the second test; however nine ( n =9) of the patients showed increased or decreased numbers of white blood cell counts and whose medical history and physical examination revealed signs and symptoms related to infection. Conclusion: Routine laboratory tests contribute little to preoperative evaluation of children with normal history and physical examination undergoing low grade surgery.