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Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy.

Abstract Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect.
PMID
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Authors

Mayor MeshTerms
Keywords

Pain

Patient-reported outcome measures

Postoperative recovery

Tonsillectomy tonsillotomy

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28390613
OWN - NLM
STAT- MEDLINE
DA  - 20170409
DCOM- 20170517
LR  - 20170517
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 96
DP  - 2017 May
TI  - Self-reported postoperative recovery in children after tonsillectomy compared to 
      tonsillotomy.
PG  - 47-54
LID - S0165-5876(17)30089-7 [pii]
LID - 10.1016/j.ijporl.2017.02.029 [doi]
AB  - OBJECTIVES: Tonsil surgery is associated with significant morbidity during
      recovery. Patient-reported outcome measures (PROM) are the golden standard for
      the planning and follow-up of delivered care, which should also be an axiom for
      children. The current aims were to describe self-reported postoperative recovery 
      in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy
      in this respect. METHODS: In total, 238 children (4-12 years old) with a history 
      of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil
      surgery were included. Forty-eight per cent were operated with partial tonsil
      resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day
      surgery. Postoperative recovery was assessed on days 1, 4 and 10 using the
      validated self-rating instrument PRiC, Postoperative Recovery in Children. This
      includes 23 items covering different aspects of recovery after tonsil surgery. A 
      higher score indicates worse status in the respective items. RESULTS: Daily life 
      activities (sleeping, eating and playing), physical symptoms (e.g., headache,
      stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination),
      and emotional aspects (sadness, frightening dreams) were affected during the
      recovery period. The TE-girls showed higher scores than the boys regarding
      stomach ache, defecation and dizziness. Children above 6 years of age reported
      higher values for the physical comfort variables, while the younger group showed 
      worse emotional states. Postoperative recovery improved from day 1-10 in all
      surgical groups. The TE-group showed lower recovery compared to the TT-group (p <
      0.01-0.001) in most items. CONCLUSION: The goal of postoperative management is to
      minimize or eliminate discomfort, facilitating the recovery process and avoiding 
      complications. Children are able to describe their recovery, and thus, PRiC seems
      to be able to serve as a PROM to obtain patient-centered data after tonsil
      surgery. The recovery process after TT causes less postoperative morbidity and a 
      quicker return to normal activity compared to TE.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Eriksson, Mats
AU  - Eriksson M
AD  - School of Health Sciences, Faculty of Medicine and Health, Orebro University,
      S-701 82 Orebro, Sweden.
FAU - Nilsson, Ulrica
AU  - Nilsson U
AD  - School of Health Sciences, Faculty of Medicine and Health, Orebro University,
      S-701 82 Orebro, Sweden.
FAU - Bramhagen, Ann-Cathrine
AU  - Bramhagen AC
AD  - Faculty of Health and Society, Department of Care Sciences, Malmo University,
      S-205 06 Malmo, Sweden.
FAU - Idvall, Ewa
AU  - Idvall E
AD  - Faculty of Health and Society, Department of Care Sciences, Malmo University,
      S-205 06 Malmo, Sweden.
FAU - Ericsson, Elisabeth
AU  - Ericsson E
AD  - School of Health Sciences, Faculty of Medicine and Health, Orebro University,
      S-701 82 Orebro, Sweden. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170301
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Palatine Tonsil/*surgery
MH  - Postoperative Complications/epidemiology/etiology
MH  - Postoperative Period
MH  - Self Report
MH  - Tonsillectomy/adverse effects/*methods
MH  - Tonsillitis/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Pain
OT  - Patient-reported outcome measures
OT  - Postoperative recovery
OT  - Tonsillectomy tonsillotomy
EDAT- 2017/04/10 06:00
MHDA- 2017/05/18 06:00
CRDT- 2017/04/10 06:00
PHST- 2016/10/18 [received]
PHST- 2017/02/20 [revised]
PHST- 2017/02/25 [accepted]
AID - S0165-5876(17)30089-7 [pii]
AID - 10.1016/j.ijporl.2017.02.029 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 May;96:47-54. doi:
      10.1016/j.ijporl.2017.02.029. Epub 2017 Mar 1.

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