Mattioni Jillian, Azari Sarah, Hoover Travis, Weaver Daniel, Chennupati Sri Kiran
Otolaryngology Head and Neck Surgery Resident, Department of Otolaryngology- Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA, 19131, USA.
University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
Int J Pediatr Otorhinolaryngol. 2019 Apr;119:171-176. doi: 10.1016/j.ijporl.2019.01.030. Epub 2019 Jan 23.
To examine complications following pediatric branchial cleft cyst excision by surgical specialty, demographics, and comorbid conditions.
A retrospective review of the National Surgical Quality Improvement Program database was performed. Pediatric cases from January 1, 2015 through May 1, 2017 with a current procedural terminology code of 42810 (excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues) or 42815 (excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into the pharynx) were included. Statistical analysis was performed to assess associations between complications and surgical specialty, demographics, and comorbidities.
Of the 895 cases that met inclusion criteria, the median age was two years and there was an approximately equal number of males (46.8%) and females (53.2%). Forty-five patients (5.0%) experienced at least one 30-day complication, the most predominant of which was superficial surgical site infection. There was no statistically significant difference between complications and surgical specialty, complications and patient demographics, or complications and depth of excision. There was a statistically significant difference (p = 0.05) in the percentage of patients with a past medical history of developmental delay between those with at least one complication (11.1%) compared to those without any complications (4.2%).
Branchial cleft excision is a generally safe procedure across surgical specialties and patient demographics. There is an association between a history of developmental delay and 30-day postoperative complications.
按手术专科、人口统计学特征及合并症情况，研究小儿鳃裂囊肿切除术后的并发症。
对国家外科质量改进计划数据库进行回顾性分析。纳入2015年1月1日至2017年5月1日的小儿病例，其当前手术操作术语编码为42810（鳃裂囊肿或遗迹切除术，限于皮肤和皮下组织）或42815（鳃裂囊肿、遗迹或瘘管切除术，延伸至皮下组织下方和/或进入咽部）。进行统计分析以评估并发症与手术专科、人口统计学特征及合并症之间的关联。
在符合纳入标准的895例病例中，中位年龄为2岁，男性（46.8%）和女性（53.2%）数量大致相等。45例患者（5.0%）经历了至少一种30天内的并发症，其中最主要的是浅表手术部位感染。并发症与手术专科、并发症与患者人口统计学特征、并发症与切除深度之间均无统计学显著差异。有至少一种并发症的患者（11.1%）与无任何并发症的患者相比，有发育迟缓既往病史的患者百分比存在统计学显著差异（p = 0.05）（4.2%）。
鳃裂切除术在各手术专科和患者人口统计学特征方面通常是安全的手术。发育迟缓病史与术后30天并发症之间存在关联。
