Haematological changes after tonsillectomy in mild thalassemia children recommendations

Objective This study aims to evaluate the alterations in peripheral blood parameters and the therapeutic outcomes following tonsillectomy in pediatric patients diagnosed with mild thalassemia. Methods We conducted a prospective cohort study involving 65 children who underwent tonsillectomy (with or without adenoidectomy) between May 2023 to March 2025. Patients with thalassemia were assigned to the anaemia group (n = 30), while those without underlying diseases who underwent surgery during the same period were included in the control group (n = 35). The changes in white blood cell count, neutrophil percentage, red blood cell count and hemoglobin level were compared between the two groups at 1-day, 7-days, 1-month, 3-months, and 6-months postoperatively. Postoperative recovery and complications were also compared. Results In both groups, white blood cell count, neutrophil percentage, red blood cell count and hemoglobin level showed significant increases at both 1-day and 7-days post-surgery compared to preoperative levels (p < 0.05). The postoperative changes in red blood cell count and hemoglobin level were significantly larger in the anaemia group than the control group at one week and one month after surgery, respectively (p < 0.05). There were no significant differences in the incidence of postoperative snoring relief, bleeding, fever, sore throat, or dizziness between the two groups (p > 0.05). Conclusion Tonsillectomy proves to be a safe and effective intervention for alleviating snoring in children with mild thalassemia. After the surgery, regular monitoring of blood parameters and routine transfusions are not required. This conclusion is supported by the absence of significant postoperative haematological deterioration or an increased risk of complications in the mild thalassemia cohort. Level of Evidence 2b.