Impact of preoperative infection severity on surgical outcomes in branchial cleft anomalies: A retrospectie cohort study

Abstract

Objective

To evaluate the association between preoperative infection severity and surgical outcomes in patients undergoing excision for branchial cleft anomalies (BCAs).

Study design

A single-center, retrospective cohort study of patients with BCAs who underwent surgical excision at Sichuan Provincial People's Hospital between August 2014 and October 2023.

Methods

Patients were categorized into non-infected (n = 58), mildly infected (n = 169), and severely infected (n = 107) groups using a preoperative infection grading system. Data collected included demographics, clinical presentation, surgical duration, intraoperative blood loss, preoperative infection-control period, postoperative hospitalization, duration of postoperative antibiotic therapy, recurrence, infection, and other complications. Conduct appropriate statistical analyses on the above data.

Results

Age and sex distributions were similar among groups, while significant differences were observed in morphology, origin, and laterality. Non-infected and mildly infected cases were predominantly cystic, whereas severely infected cases had higher proportions of fistulae and sinuses. Preoperative infection-control periods differed significantly (P < 0.001), with longer durations in severely infected patients. Surgery duration, intraoperative blood loss, postoperative hospital stay, and duration of postoperative antibiotics increased with infection severity (all P < 0.01). No recurrence or postoperative infection occurred in the non-infected group. Mildly infected patients had low recurrence (2 %) and infection rates (4 %), while severely infected patients showed higher recurrence (8 %) and infection rates (18 %). Most events occurred within the first postoperative year.

Conclusion

Preoperative infection severity in BCAs significantly affects surgical complexity, postoperative recurrence, and infection. Careful infection control prior to surgery is crucial, particularly for severely infected cases, to optimize outcomes and minimize complications.