Is postoperative hemorrhage a risk in ambulatory tonsillectomy

: Day-case surgery is being used increasingly to improve health care efficiency. In Denmark, tonsillectomy is performed on an in-patient basis because of safety concerns regarding primary haemorrhage. This study aims at investigating the likely safety of day-case tonsillectomy by defining the incidence and timing of primary haemorrhage and thereby to establish a safe time period for a possible same day discharge. Retrospectively recorded data on 2,888 tonsillectomies were reviewed. Serious primary posttonsillectomy haemorrhage arose in 34 patients (2.7 percent), of which 65 percent presented within eight hours and 95 percent within 23 hours postoperatively. In view of the fact that one quarter of the patients with a primary posttonsillectomy haemorrhage experience it more than 12 hours postoperatively, tonsillectomy cannot be recommended as a safe routine day-case procedure.