Is day surgery tonsillectomy safe? A consecutive surgery case-series in an Australian setting

Objectives: To assess the outcomes of a protocol-led, same-day discharge for elective tonsillectomy patients. 

Design: A retrospective case-series of all tonsillectomies performed from January 2018 to May 2023 at a tertiary hospital in Adelaide, Australia. The primary outcome was rate of readmission within 24 hours for same-day surgery compared to hospital-stay tonsillectomy patients. Secondary outcomes included post-tonsillectomy haemorrhage. 

Results: During the study period, 1658 elective tonsillectomies were performed, with 664 patients (40.0 per cent) discharged the same day following tonsillectomy. The readmission rate within 24 hours was comparable between the two groups: 0.60 per cent for day surgery and 0.64 per cent for those who stayed overnight in hospital (Χ2(1, N = 1600) = 0.009, p = 0.9244). The primary post-tonsillectomy haemorrhage rate for day-surgery patients was 0.3 per cent, with a relative risk of 0.5 (Χ2(1, N = 1658) = 0.751, p = 0.3862). 

Conclusion: The low readmission and primary post-tonsillectomy haemorrhage rates indicate that a protocol-led, same-day tonsillectomy is safe and feasible to implement in carefully selected patients.