{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:35:31Z","timestamp":1790087731069,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"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":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Swan Hill District Health (SHDH) provides Otolaryngological services to outer regional Victoria. A preoperative checklist determines eligibility for tonsillectomy, and the role of preoperative investigations such as oximetry. Visiting specialists who provide T&amp;A also remain on\u2010site for 24\u2009h post\u2010surgery. Management of post\u2010discharge complications is supported by SHDH's Emergency Department. Unstable patients are transferred to tertiary care hospitals. This study examines the safety outcomes associated with rural Tonsillectomy and adenotonsillectomy (T&amp;A) and the impact of peri\u2010operative protocols on these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study of all paediatric (2\u201318\u2009years old) patients undergoing T&amp;A from August 2014 to June 2020 at SHDH. Four external hospital databases which accept patient transfers from SHDH were searched for T&amp;A\u2010related complications. The primary outcome was complication incidence. Secondary outcomes were length of stay, and rates of hospital readmissions, return to theatre and inter\u2010hospital transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and four patients were included, with median age 6\u2009years old; 68.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0139\/204) had obstructive sleep apnoea, or sleep disordered breathing, wherein 36.0% (<jats:italic>n<\/jats:italic>\u00a0=\u00a050\/139) had documented evidence of normal\/inconclusive oximetry. The complication rate is 6.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a014\/204), with two intraoperative, five perioperative and seven post\u2010discharge complications. All intra\u2010 and peri\u2010operative complications were managed locally. All post\u2010discharge complications presented to outer regional EDs. Two patients required inter\u2010hospital transfer for monitoring of post\u2010tonsillectomy bleeds in a specialist unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who pass a preoperative risk checklist can safely undergo T&amp;A in selected rural settings which adhere to strict patient selection criteria and implement safety measures to address complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17637","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T06:04:44Z","timestamp":1648533884000},"page":"1401-1406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Paediatric tonsillectomy and adenotonsillectomy in a rural setting: a retrospective study over a period of 6\u2010years"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-5986","authenticated-orcid":false,"given":"Seraphina","family":"Key","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health, Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Alnimri","sequence":"additional","affiliation":[{"name":"Department of Surgery University Hospital Geelong  Geelong Victoria Australia"},{"name":"Department of Surgery St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair","family":"Ney","sequence":"additional","affiliation":[{"name":"Department of Surgery St Vincent's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Department of Surgery Swan Hill District Health  Swan Hill Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"De Freitas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health, Melbourne  Victoria Australia"},{"name":"Department of Surgery Swan Hill District Health  Swan Hill Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Paddle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery Monash Health, Melbourne  Victoria Australia"},{"name":"Department of Surgery Swan Hill District Health  Swan Hill Victoria Australia"},{"name":"Department of Surgery, Faculty Medicine, Nursing &amp; Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/20786204.2012.10874231"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.11.004"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818801757"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.03.015"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/4101034"},{"key":"e_1_2_11_7_1","unstructured":"Australian Institute of Health and Welfare.Admitted patient care: 2017\u201018 [Internet]. 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