{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:52:41Z","timestamp":1790927561213,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Tonsillectomy is the most common operation performed by otolaryngologists in the UK, despite this we have a poor understanding of the post\u2010operative recovery. We aimed to investigate post\u2010operative bleeding and pain following paediatric tonsillectomy using a patient diary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multi\u2010centre study involving 12 secondary and tertiary otolaryngology units across the North of England. Patients were recruited from 1st March 2020 to 30th June 2022. Multilevel ordered logistic regression model statistics were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children (\u22654\u2009years, \u226416\u2009years) undergoing tonsillectomy (with or without adenoidectomy) for benign pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>\n                      <jats:list>\n                        <jats:list-item>\n                          <jats:p>Frequency and severity of post\u2010operative bleeding.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Intensity and pattern of post\u2010operative pain.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total 297 children were recruited, with 91 (30.6%) diaries eligible for analysis. Post\u2010operative bleeding occurred in 44% of children. Most frequently blood in the saliva was reported (82.9%). Increasing age significantly increased bleeding odds by 17% per year (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). Bleeding frequency decreased with higher surgeon grade (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.003) and when performing intracapsular coblation tonsillectomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02) compared with other techniques. Lower age and intracapsular coblation tonsillectomy, against other techniques, significantly reduced rates of pain post\u2010operatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.0008).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high level of low\u2010level post\u2010operative bleeding was observed. Pain scores remained high for 5\u2009days post\u2010operatively then gradually reduce to normal by day 13. Intracapsular coblation tonsillectomy appears to be superior to all other techniques in terms of reducing post\u2010operative bleeding and pain. These findings should be used to guide patients in the consent process to inform them of the expected nature of post\u2010surgical recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14110","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T02:54:05Z","timestamp":1698893645000},"page":"176-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The post\u2010operative tonsillectomy (POPT) study: A multi\u2010centre prospective paediatric cohort study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9692-646X","authenticated-orcid":false,"given":"Elliot","family":"Heward","sequence":"first","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-0246","authenticated-orcid":false,"given":"John","family":"Rocke","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"McNally","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9955-4107","authenticated-orcid":false,"given":"Gabrielle","family":"Thompson","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dare","family":"Oladokun","sequence":"additional","affiliation":[{"name":"York and Scarborough Teaching Hospitals NHS Foundation Trust  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Timms","sequence":"additional","affiliation":[{"name":"Bolton NHS Foundation Trust  Bolton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M. H.","family":"Chu","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-5783","authenticated-orcid":false,"given":"Sarah","family":"Akbar","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sian","family":"Dobbs","sequence":"additional","affiliation":[{"name":"Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-8359","authenticated-orcid":false,"given":"Dorota","family":"Chudek","sequence":"additional","affiliation":[{"name":"Wrightington, Wigan and Leigh NHS Foundation Trust  Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-4469","authenticated-orcid":false,"given":"Ishank","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Lancashire Teaching Hospitals NHS Foundation Trust  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devan","family":"Vora","sequence":"additional","affiliation":[{"name":"East Lancashire Hospitals NHS Trust  Blackburn UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Harrison","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-323X","authenticated-orcid":false,"given":"Babatunde","family":"Oremule","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-0203","authenticated-orcid":false,"given":"Safdar","family":"Sarwar","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini S.","family":"Menon","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Advani","sequence":"additional","affiliation":[{"name":"Lancashire Teaching Hospitals NHS Foundation Trust  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Daniels","sequence":"additional","affiliation":[{"name":"Bolton NHS Foundation Trust  Bolton 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Venugopal","sequence":"additional","affiliation":[{"name":"Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Beena","sequence":"additional","affiliation":[{"name":"Blackpool Teaching Hospitals NHS Foundation Trust  Blackpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirwa","family":"Sheik\u2010ali","sequence":"additional","affiliation":[{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust  Ashton\u2010under\u2010Lyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2624-0518","authenticated-orcid":false,"given":"Haroon","family":"Saeed","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester 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Programme National Speciality Report","author":"Marshall A","year":"2019"},{"key":"e_1_2_15_3_1","volume-title":"National Prospective Tonsillectomy Audit: Final Report of an Audit Carried Out in England and Northern Ireland Between July 2003 and September 2004","author":"Royal College of Surgeons, England","year":"2005"},{"key":"e_1_2_15_4_1","article-title":"Measurement of the true incidence of secondary Haemorrhage post tonsillectomy","author":"Holmes L","year":"2018","journal-title":"Surg Med Open Access J"},{"issue":"4","key":"e_1_2_15_5_1","article-title":"Tonsillectomy and adenoidectomy: indications, complications and their management","volume":"4","author":"Anmolsingh R","year":"2018","journal-title":"J Surg: Open 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Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.14110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T01:39:12Z","timestamp":1707961152000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.14110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/coa.14110"],"URL":"https:\/\/doi.org\/10.1111\/coa.14110","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/COA.14110\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14110\/v2\/review1","asserted-by":"object"}]},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"2023-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}