Van Horn Adam J, Goldman Richard A, Charnigo Richard J, Johnson Kai C, Valentino Joseph, Aouad Rony K
Department of Otolaryngology, Head and Neck Surgery, University of Kentucky, 800 Rose Street, C-240, Lexington, KY, 40536, USA.
Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3437-3442. doi: 10.1007/s00405-017-4641-5. Epub 2017 Jun 14.
The objective of this manuscript is to review a single institution's experience with superficial or total parotidectomy in outpatient and observation/inpatient groups. All patients who underwent superficial or total parotidectomy between 2009 and 2015 were identified. Patients were excluded if they had undergone concurrent surgery such as neck dissection, had prior radiation treatment or surgery at the operative site. Main outcomes were perioperative complications in both groups. 215 consecutive patients were included in the study, 116 (54%) patients in the inpatient group and 99 (46%) in the outpatient group. Aside from a higher observed rate of cardiac disease in the outpatient group (24.2 vs. 11.2%, p = 0.014) and larger mean body mass index (BMI) in the inpatient group (32.448 vs. 30.034, p = 0.017), there were no significant differences for age, sex or smoking status. Average operative time differed between groups with 2 h 42 min for inpatients and 2 h 18 min for outpatients (p < 0.001). There were 26 complications in the inpatient group (22.4%, including two hematomas) and 8 in the outpatient group (8.1%). The rate of seroma/sialocele formation was significantly higher in the inpatient group at 15.5% (n = 18) compared with the outpatient group at 3% (n = 3, p = 0.001). Our study shows that parotidectomy, superficial or total, was performed safely as an outpatient procedure without significant increase in complications when compared to patients observed for at least one night after surgery.
本手稿的目的是回顾一家机构在门诊和观察/住院患者组中进行浅叶或全腮腺切除术的经验。确定了2009年至2015年间接受浅叶或全腮腺切除术的所有患者。如果患者同时接受了如颈部清扫等手术、在手术部位曾接受过放疗或手术,则将其排除。主要结局是两组的围手术期并发症。215例连续患者纳入研究,住院患者组116例(54%),门诊患者组99例(46%)。除门诊患者组中观察到的心脏病发生率较高(24.2%对11.2%,p = 0.014)以及住院患者组的平均体重指数(BMI)较大(32.448对30.034,p = 0.017)外,年龄、性别或吸烟状况无显著差异。两组的平均手术时间不同,住院患者为2小时42分钟,门诊患者为2小时18分钟(p < 0.001)。住院患者组有26例并发症(22.4%,包括2例血肿),门诊患者组有8例(8.1%)。住院患者组血清肿/涎囊肿形成率显著高于门诊患者组,分别为15.5%(n = 18)和3%(n = 3,p = 0.001)。我们的研究表明,与术后至少观察一晚的患者相比,浅叶或全腮腺切除术作为门诊手术安全进行,且并发症无显著增加。