{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:37:22Z","timestamp":1790087842996,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subtotal tonsil surgery (tonsillotomy) remains a controversial procedure. We aimed to document bleeding rates and return to normal activity for total versus subtotal tonsil surgery in the paediatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 10\u2010year cohort of 608 children from a single\u2010surgeon series was analysed. Bleeding events were classified using the Flinders modification of the Stammberger criteria. Return to normal activity was defined as normal diet and return to childcare\/school.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 8.3% of tonsil procedures and a subtotal of 1.8% of procedures had some kind of bleeding episode (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01; odds ratio 3.2; 95% confidence interval (CI) 1.3\u20137.6). When blood\u2010stained sputum (type A bleed) was excluded, this dropped to 2.5% versus 0.3%, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05; odds ratio 8.5; 95% CI 1.2\u201396.0). Return to normal activities occurred at a mean of 11.1 (95% CI 9.7\u201312.5) versus 4.6 (95% CI 4.0\u20135.3) days, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this 10\u2010year single surgeon series, subtotal tonsillectomy or \u2018tonsillotomy\u2019 was associated with a significant reduction in both prevalence and severity of bleeding, in addition to a more rapid return to normal activities when compared to total tonsillectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16306","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T09:44:37Z","timestamp":1600854277000},"page":"2532-2536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Paediatric patient bleeding and pain outcomes following subtotal (tonsillotomy) and total tonsillectomy: a 10\u2010year consecutive, single surgeon series"],"prefix":"10.1111","volume":"90","author":[{"given":"Sara","family":"Attard","sequence":"first","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7507-7983","authenticated-orcid":false,"given":"Andrew Simon","family":"Carney","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.12.028"},{"key":"e_1_2_8_3_1","first-page":"144","volume-title":"The First Australian Atlas of Healthcare Variation","author":"Australian Council on Safety and Quality in Health Care","year":"2015"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2007.09.021"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2011.72.10.565"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.04.041"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.02.012"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.11.007"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2374-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818810507"},{"key":"e_1_2_8_11_1","first-page":"29","article-title":"Intracapsular versus extracapsular dissection tonsillectomy for adults: a systematic review","volume":"29","author":"Amin N","year":"2019","journal-title":"Laryngoscope"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817700374"},{"key":"e_1_2_8_13_1","unstructured":"National Health and Medical Reasearch Council.National Statement on Ethical Conduct in Human Research. 2007. 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