Can Tonsillectomy Be Safely Performed by Residents? A Comparative Retrospective Study

Abstract

Objective:

To assess whether a surgeon’s level of training is associated with outcomes in pediatric tonsillectomy.

Design:

A retrospective cohort study of the outcomes of pediatric tonsillectomies performed between 2006 and 2016 by senior surgeons versus resident surgeons under the supervision of senior surgeons.

Setting:

An otolaryngology department in a tertiary academic hospital.

Patients:

Children younger than 18 years who underwent bilateral tonsillectomy with or without adenoidectomy.

Main outcome measures:

Intraoperative bleeding, initiation of oral intake, and intraoperative and postoperative complications.

Results:

Of 785 children, 397 (50.5%) were operated on by a resident surgeon and 388 (49.5%) by a senior surgeon. Patient demographics and surgical techniques were similar between the groups. The mean surgical time was 33.2 minutes in the residents’ group and 27.1 minutes in the seniors’ group (P = .032). The groups were similar in intraoperative bleeding, while same-day initiation of oral intake was 71% for children in the residents’ group versus 61% in the seniors’ group (P = .28). Reports of postoperative bleeding necessitating readmission and revised operations were similar for both groups (3.0% and 0.7%, respectively, in the residents’ group; and 2.5% and 1.0%, respectively, in the seniors’ group).

Conclusion:

Children undergoing tonsillectomy showed similar short-term outcomes, whether the operations were performed by a senior surgeon or a resident surgeon supervised by an attending surgeon. This study demonstrates the safety of pediatric tonsillectomy performed by resident surgeons supervised by attending physicians.