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在接受西斯特伦克手术的患者中,放置引流管对术后并发症有任何益处吗?

Is There Any Benefit of Drain Placement on Postoperative Complications in Patients Undergoing the Sistrunk Procedure?

作者信息

Qureshi Talha Ahmed, Suhail Anwar, Zaidi Syed Sajjad Ali, Siddiq Wasif

机构信息

Section of Otolaryngology Head-Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Int Arch Otorhinolaryngol. 2015 Oct;19(4):331-5. doi: 10.1055/s-0035-1549156. Epub 2015 Mar 27.

Abstract

Introduction Same-day, outpatient Sistrunk procedure is commonly performed to manage thyroglossal duct cyst anomalies and may lead to postoperative complications. Surgical drains are placed to prevent complications, but recent observations show no advantage and rather increased health care costs and patient discomfort. Objective The study evaluated if drain placement in the Sistrunk procedure offers any benefit on postoperative complications. Methods A retrospective analysis of patient records having undergone same-day, outpatient Sistrunk procedure from 2004 to 2014 was done. Of 58 (38 male and 20 female) patients included, 38 did not have drains placed and the remaining 20 had drains placed. Mean and median age of patients was 18.1 and 13.5 years, respectively. Postoperative complications of patients with drains versus those without drains were statistically analyzed. Results Overall, about 10% of patients had hematoma/seroma (H-S), with 6.9% of patients needing aspiration for H-S; 3.4% had wound infections; and 1.7% had pus formation. No statistically significant differences in Sistrunk-related complications between patient groups (with drain or without drain) were seen using Fisher exact (two-sided) test: H-S (p = 0.08); need for aspiration (p = 0.29); wound infection (p > 0.05); and pus formation (p = 0.35). Chi-square test also did not show any significant difference in the groups in terms of number of follow-ups. Conclusion Surgical placement of a drain in the Sistrunk procedure does not seem to offer any advantage in terms of reducing common postoperative complications. Same-day Sistrunk procedure without any drain placement may be a safer alternative without necessitating hospitalization. More studies with larger sample size are needed for further substantiation.

摘要

引言

当日门诊Sistrunk手术常用于治疗甲状舌管囊肿异常,可能会导致术后并发症。放置手术引流管以预防并发症,但最近的观察表明并无益处,反而增加了医疗成本和患者不适。目的:本研究评估Sistrunk手术中放置引流管对术后并发症是否有任何益处。方法:对2004年至2014年接受当日门诊Sistrunk手术的患者记录进行回顾性分析。纳入的58例患者(38例男性和20例女性)中,38例未放置引流管,其余20例放置了引流管。患者的平均年龄和中位年龄分别为18.1岁和13.5岁。对放置引流管与未放置引流管患者的术后并发症进行统计学分析。结果:总体而言,约10%的患者出现血肿/血清肿(H-S),6.9%的患者因H-S需要抽吸;3.4%的患者发生伤口感染;1.7%的患者出现脓液形成。使用Fisher精确(双侧)检验,患者组(有引流管或无引流管)之间在Sistrunk相关并发症方面未见统计学显著差异:H-S(p = 0.08);抽吸需求(p = 0.29);伤口感染(p>0.05);脓液形成(p = 0.35)。卡方检验在随访次数方面也未显示组间有任何显著差异。结论:Sistrunk手术中手术放置引流管在减少常见术后并发症方面似乎没有任何优势。当日进行的无引流管放置的Sistrunk手术可能是一种更安全的选择,无需住院。需要更多样本量更大的研究来进一步证实。

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