When the tonsils have to be removed and why so many children are operated without need

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The study found that nine out of 10 of these operations in England – 88% – are not necessary.

Thousands of children undergo tonsillectomy every year – the surgical removal of the tonsils – without needing them.

A study conducted in England found that nine out of 10 of these operations in this country – 88% – are not necessary.

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And he warns that the surgical procedure could cause more harm than good in children, in addition to the costs that this entails for the health system of the country.

The study, published in the British Journal of General Medicine, analyzed the records of over 1.6 million children between 2005 and 2016.

He found that of over 18,000 children undergoing tonsillectomy during that period, only in 2.144 (about 12%) was justified medically the operation.

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No 32,500 of the 37,000 childhood tonsillectomies in the UK are needed between 2016 and 2017.

criteria

As the researchers explain, tonsillectomy should only be offered when one of the main criteria is met:

  • More than seven documented episodes of pain or throat inflammation in the year.
  • More than five episodes of pain or inflammation of the throat during two consecutive years.
  • Three episodes of pain or swelling of the throat a year for three consecutive years.

The study states that one in 10 children had suffered only one episode of sore throat or inflammation before the intervention was offered.

He added that two or three children in 1,000 were subjected to tonsillectomy annually between 2005 and 2016, but only one in eight met the recommended criteria.

Based on these data, the study estimates that 32,500 of the 37,000 childhood tonsillectomies performed in the UK between 2016 and 2017 were not necessary, costing US $ 48.5 billion in national health services.

Professor Tom Marshall, of the Applied Health Research Institute of the University of Birmingham, England, one of the authors of the study, says that tonsillectomies can be justified with the most severely affected patients.

But he adds that "research suggests that children with less pain or sore throat will not benefit enough to justify surgery, because, in any case, the sore throat tends to happen."

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Studies show that tonsillectomies are performed in children in different countries without medically justifying the operation.

The problem is not unique in the United Kingdom.

Although the figures vary from country to country and within countries, the research was published in 2014 a The Cochrane review, which carried out a comparison of studies conducted in several countries on the efficacy of tonsillectomy, revealed that a large number of these operations are performed without sufficient medical justification.

Data from the European Union show that in 2015 tonsillectomy rates in the Netherlands, Belgium, Finland and Norway were three times higher than in the United Kingdom.

But the United States is the country with the highest rates of this surgical procedure. Every year they are kept there more than 500,000 tonsillectomies in children and is the third most common childhood surgical operation in the country.

The costs of the procedure are so high that too Tonsillectomies have been described as "an epidemic".

"It's a silent epidemic of unnecessary medical care," said David Goodman of the Darthouth Atlas in 2012, a health care database of the Darmouth Institute for Health Policy and Clinical Practice.

"In most cases, it's done in patients with symptoms that are much less recurrent than those that should be indicated," Goodman said.

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Although the complications of the operation are rare, they can be serious.

complications

Experts also point out that, as with all surgical procedures, tonsillectomies can lead to complications that, although rare, can be serious.

"When this is done in the right group of children, it can significantly reduce throat infections, improve sleep quality, visits to the doctor, use of antibiotics and, above all, improve the quality of life of the child. child and his family, "say experts at McGovern Medical School at the University of Texas.

"However, there is a morbidity associated with the operation that it includes hospitalization, financial cost, risk of anesthesia, postoperative bleeding and scars ", they add.

"In fact, up to 4% of affected children can be readmitted due to secondary complications, which means that making the right decisions for this intervention is of paramount importance."

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