Daniel J Lee, David Forner, Christopher End, Christopher M K L Yao, Shireen Samargandy, Eric Monteiro, Ian J Witterick, Jeremy L Freeman
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引用次数: 6
Abstract
Background: Superficial parotidectomy has a potential to be performed as an outpatient procedure. The objective of the study is to evaluate the safety and selection profile of outpatient superficial parotidectomy compared to inpatient parotidectomy.
Methods: A retrospective review of individuals who underwent superficial parotidectomy between 2006 and 2016 at a tertiary care center was conducted. Primary outcomes included surgical complications, including transient/permanent facial nerve palsy, wound infection, hematoma, seroma, and fistula formation, as well as medical complications in the postoperative period. Secondary outcome measures included unplanned emergency room visits and readmissions within 30 days of operation due to postoperative complications.
Results: There were 238 patients included (124 in outpatient and 114 in inpatient group). There was no significant difference between the groups in terms of gender, co-morbidities, tumor pathology or tumor size. There was a trend towards longer distance to the hospital from home address (111 Km in inpatient vs. 27 in outpatient, mean difference 83 km [95% CI,- 1 to 162 km], p = 0.053). The overall complication rates were comparable between the groups (24.2% in outpatient group vs. 21.1% in inpatient, p = 0.56). There was no difference in the rate of return to the emergency department (3.5% vs 5.6%, p = 0.433) or readmission within 30 days (0.9% vs 0.8%, p = 0.952).
Conclusion: Superficial parotidectomy can be performed safely as an outpatient procedure without elevated risk of complications.
背景:腮腺浅表性切除术有可能作为门诊手术进行。本研究的目的是评价门诊腮腺浅表性切除术与住院腮腺切除术的安全性和选择概况。方法:回顾性分析2006年至2016年在某三级医疗中心行腮腺浅表性切除术的患者。主要结局包括手术并发症,包括一过性/永久性面神经麻痹、伤口感染、血肿、血肿和瘘管形成,以及术后的医学并发症。次要结局指标包括意外急诊室就诊和手术后30天内因术后并发症再入院。结果:共纳入238例患者,其中门诊组124例,住院组114例。两组在性别、合并症、肿瘤病理或肿瘤大小方面无显著差异。从家庭住址到医院的距离有增加的趋势(住院病人111公里,门诊病人27公里,平均差83公里[95% CI,- 1至162公里],p = 0.053)。两组间的总并发症发生率具有可比性(门诊组24.2% vs住院组21.1%,p = 0.56)。在急诊科的复诊率(3.5% vs 5.6%, p = 0.433)和30天内的再入院率(0.9% vs 0.8%, p = 0.952)方面没有差异。结论:腮腺浅表性切除术可以作为一种安全的门诊手术,不会增加并发症的风险。