Paediatric Adenoidectomy: A Retrospective Cohort Study of Clinical Practice and Outcomes in NHS England (2008–2024)

OBJECTIVES: To examine trends and outcomes for paediatric adenoidectomies in NHS England between 2008 and 2024. DESIGN: Retrospective observational cohort study using Hospital Episode Statistics. SETTING: NHS trusts in England. PARTICIPANTS: Children (≤ 16 years) undergoing adenoidectomy. MAIN OUTCOME MEASURES: Adenoidectomies and concurrent procedures performed. In-hospital complications and readmissions within 28 days. All-cause mortality and revision procedures. RESULTS: Between 2008 and 2024, 351 540 adenoidectomies were performed; 305 922 alongside ventilation tube insertion and/or tonsillectomy and 45 618 without these concurrent procedures. In-hospital complications occurred in 4422 admissions (1.3%) and 21 398 patients (6.1%) were readmitted within 28 days. Across all cases, the rate of haemorrhage was 3.4%, while in adenoidectomies occurring in the absence of concurrent ventilation tube insertion and/or tonsillectomy, the overall rate of haemorrhage was 0.7%, and 0.16% cases required return to theatre for surgical arrest of haemorrhage from the adenoid. Over the study period, emergency readmission rates rose from 3.8% to 6.7% while the proportion of day-case procedures increased from 46.3% to 81.1%. For adenoidectomies without concurrent ventilation tube insertion and/or tonsillectomy the rate of emergency admission rose from 2.07% to 2.91%, while adenoidectomies occurring concurrently alongside these procedures rose from 4.61% to 7.52%. The estimated overall revision rate was 4.52% (95% CI 4.44%-4.61%). CONCLUSIONS: This study describes key outcomes, providing the basis for accurate preoperative counselling in paediatric adenoidectomy. However, clinical coding does not capture surgical indication or technique, limiting procedure-specific assessment. Improved coding and prospective research are critically needed to examine technique-specific outcomes.