Kaye Alison, Che Columbine
1 Division of Plastic Surgery, Children's Mercy Hospital, Kansas City, MO, USA.
2 University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Cleft Palate Craniofac J. 2019 Feb;56(2):196-203. doi: 10.1177/1055665618774020. Epub 2018 May 9.
To determine the degree of weight loss, time to regain lost weight, and impact on postoperative outcomes after primary cleft lip (CL) and cleft palate (CP) repair.
Single institution retrospective.
Two hundred seven patients who underwent primary CL and/or CP repair procedures.
One hundred thirty primary CL repairs (isolated CL = 59; cleft lip and palate [CLP] = 71) and 140 primary CP repairs (isolated CP = 72; CLP = 69): At the first postoperative visit, 21.54% of CL and 57.14% of CP repair patients had not returned to their immediate preoperative weights ( P < .0001). Maximum weight loss after CL repair was 0.44 kg (mean = 0.15 kg; standard deviation [SD]: 0.11) and for CP repair was 0.85 kg (mean = 0.31 kg; SD: 0.21; P = .002). Maximum percentage body weight loss was 6.11% after CL repair (mean = 2.08%; SD: 1.56) and 9.2% after CP repair (mean = 3.10%; SD: 2.13; P = .02). If not returned to preoperative weight by first postoperative visit, CP repair took significantly longer. Median time to return to preoperative weight was CL = 14.08 days (interquartile range [IQR]: 7.26) and CP = 25.37 days (IQR: 21.07; P < .0001). Patients undergoing CP repair with slowed weight recovery had a 22.5% rate of unintentional fistula/partial dehiscence compared to 10.0% of those who recovered quickly ( P = .052).
Primary CP repair involves significantly higher risk and degree of postoperative weight loss and slower rates of weight recovery when compared with primary CL repair. Postoperative weight loss is associated with increased risk of complications with palatal healing. Cleft palate repair patients should be monitored closely for weight recovery and considered for nutritional interventions to support improved postoperative outcomes.
确定一期唇裂（CL）和腭裂（CP）修复术后的体重减轻程度、恢复体重所需时间以及对术后结局的影响。
单机构回顾性研究。
207例行一期CL和/或CP修复手术的患者。
130例一期CL修复术（单纯CL = 59例；唇腭裂[CLP] = 71例）和140例一期CP修复术（单纯CP = 72例；CLP = 69例）：术后首次随访时，21.54%的CL修复患者和57.14%的CP修复患者尚未恢复至术前即时体重（P <.0001）。CL修复术后最大体重减轻为0.44 kg（均值 = 0.15 kg；标准差[SD]：0.11），CP修复术后为0.85 kg（均值 = 0.31 kg；SD：0.21；P =.002）。CL修复术后最大体重减轻百分比为6.11%（均值 = 2.08%；SD：1.56），CP修复术后为9.2%（均值 = 3.10%；SD：2.13；P =.02）。若术后首次随访时未恢复至术前体重，CP修复恢复时间显著更长。恢复至术前体重的中位时间为CL = 14.08天（四分位间距[IQR]：7.26），CP = 25.37天（IQR：21.07；P <.0001）。体重恢复缓慢的CP修复患者发生无意性瘘管/部分裂开的比例为22.5%，而恢复迅速的患者为10.0%（P =.052）。
与一期CL修复相比，一期CP修复术后体重减轻的风险和程度显著更高，体重恢复速度更慢。术后体重减轻与腭部愈合并发症风险增加相关。应密切监测腭裂修复患者的体重恢复情况，并考虑采取营养干预措施以改善术后结局。
