Postoperative Hemostasis Rate following Tonsillectomy at a Singapore Pediatric Tertiary Hospital

Objectives: Tonsillectomies and adenotonsillectomies are among the most common procedures to be carried out in children throughout the world. Postoperative hemorrhages have previously been reported to be at a maximum expected rate of 13.9% with a mean of 4.5%. This study reports the postoperative hemostasis rate at the KK Women's and Children Hospital, Singapore, a tertiary pediatric hospital. Methods: Retrospective study of tonsillectomy and adenotonsillectomy cases done on children up to 16 years of age from the end of January 2007 till early January 2013. The number of postoperative bleeds that required return to the operating room for hemostasis was recorded. Results: In total there were 2322 tonsillectomy cases. 1581 were adenotonsillectomies, and 741 were bilateral tonsillectomies only (without adenoidectomy). There were 33 cases that required return to the operating room for hemostasis, giving a postoperative hemostasis rate of 1.42%. There were no cases of bleeding from adenoidectomy. All 2322 cases were done with monopolar diathermy. Hemostasis intraoperatively was also done with monopolar diathermy. The operating surgeons ranged from first year residents to senior consultants. Conclusions: The postoperative hemostasis rate following tonsillectomy and adenotonsillectomy at KK Women's and Children's Hospital is 1.42%, comparable to the best rates quoted in the literature.