Postoperative bleeding after tonsillectomy between 1985 and 2001 and experiences to perform lasertonsillotomy

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: 10052 patients after tonsillectomy were measured, 7663 were performed in the ORL-Department of Wurzburg, 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 Wurzburg was found within the first 24 hours after surgery. A second spike showed between the 5th and 7th postoperative day, an other after the 8th and 15th postoperative day. In the ORL-Department Augsburg the main spike was found from the 7th until the 9th 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.