Peer-reviewed article
Operative time and outcomes of intracapsular Tonsillectomy: Impact of patient factors and surgical trainee participation.
Heslop G, Soaper A, Aklasu G, Tabangin M, Li C ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines intracapsular tonsillectomy in 236 children, comparing operative times and outcomes when procedures were performed by surgical trainees versus attending surgeons. The study found that trainee involvement increased operative time but did not increase postoperative complications. Post-tonsillectomy hemorrhage occurred in only 1.4% of cases, all in procedures performed by attending surgeons alone.
Key points
- 236 children underwent intracapsular tonsillectomy, with mean age 5.6 years
- 38.4% of procedures involved surgical trainees under attending supervision
- Trainee involvement increased operative time significantly (28.6 vs. 20.3 minutes, p < 0.001)
- Post-tonsillectomy hemorrhage rate was 1.4%, with no cases in trainee-performed procedures
- No significant difference in postoperative complications between trainee and attending-performed procedures
Limitations
This is a surgical outcomes study focused on operative efficiency and safety rather than child well-being or health outcomes. The document does not evaluate whether the surgery itself improves children's health or quality of life, only the technical and safety aspects of the procedure.
Abstract
Objective Intracapsular tonsillectomy (IT) is an increasingly utilized technique and was recently adopted in this quaternary care children's hospital. This study evaluates the impact of patient characteristics and surgical trainee participation on operating time and postoperative clinical outcomes in a cohort of children who underwent IT. Methods A retrospective review was performed on patients ages <18 years who underwent IT from August 2023 to August 2024. Demographics, indications, trainee involvement, operative times, and postoperative complications were collected. Factors associated with operative times and complications were analyzed. Results Two-hundred and thirty-six patients underwent IT. The mean age was 5.6 ± 2.7 years and 47.1% of participants were female. Indications for surgery were sleep disordered breathing (96.2%) and recurrent tonsillitis (8.9%). Ninety-one (38.4%) procedures were performed by a trainee (resident or fellow) under supervision. Operative time was significantly higher in procedures performed by trainees compared to those performed by attending surgeons alone (28.6 vs. 20.3 min, p < 0.001. Weight, BMI-Z, and recurrent tonsillitis diagnosis were not significantly associated with operative time. Post-tonsillectomy hemorrhage rate was 1.4%, with one (0.4%) patient returning to the operating room. All patients with hemorrhage underwent IT performed by an attending surgeon alone. No other postoperative complications were observed. Discussion IT can be safely performed with trainees under supervision by an attending surgeon, without increased risk of adverse outcomes. Overall, postoperative complications are rare. Trainee involvement does confer increased operative time and can influence operating room efficiency.