University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2021 Jan;131(1):E190-E195. doi: 10.1002/lary.28688. Epub 2020 Apr 20.
OBJECTIVES/HYPOTHESIS: A carotid body tumor (CBT) is a rare type of tumor that is divided among multiple surgical specialties. Individual surgeons may have limited experience in treating these tumors. We aim to compare different surgical specialties within a single healthcare system to detect variations in management and outcome.
Retrospective chart review.
A chart review of all patients who underwent surgery for CBT at the University of Pittsburgh Medical Center (UPMC) from 2000 to 2019 was carried out. Univariate and multivariate analysis was used for descriptive statistics, comparison of outcomes, and identification of risk factors.
Fifty-eight CBT resection surgeries were performed at UPMC. Patients with advanced tumor were 6.7 (95% confidence interval [CI]: 1.36-32.7) times more likely to undergo preoperative embolization and 8.53 (95% CI: 2.011-36.19) times more likely to sustain carotid artery injury. Advanced-stage tumor resections were associated with greater blood loss (P = .03) and longer hospitalization (P = .02). Collaborative surgeries were associated with higher rates of carotid artery injury (P = .003), residual tumor (P < .001), and longer hospitalization (P = .003), as these combined cases were generally reserved for advanced-stage tumors (P = .02). There were no differences in outcomes between specialties. Of 22 surgeons, the median number of surgeries per surgeon was one (range = 1-12, 54.5%).
Surgeons who completed only one surgery for CBT had a greater rate of hospital readmission and greater length of hospital stay. Collaborative surgeries had worse outcomes due to more advanced tumors requiring more complex surgeries.
4 Laryngoscope, 131:E190-E195, 2021.
目的/假设：颈动脉体瘤（CBT）是一种罕见的肿瘤，分布在多个外科专业领域。个别外科医生在治疗这些肿瘤方面可能经验有限。我们旨在比较单一医疗体系内的不同外科专业，以发现治疗方法和结果的差异。
回顾性图表审查。
对 2000 年至 2019 年期间在匹兹堡大学医学中心（UPMC）接受 CBT 手术的所有患者进行了图表回顾。使用单变量和多变量分析进行描述性统计、结果比较和风险因素识别。
在 UPMC 进行了 58 例 CBT 切除术。晚期肿瘤患者接受术前栓塞的可能性高 6.7 倍（95%置信区间[CI]：1.36-32.7），发生颈动脉损伤的可能性高 8.53 倍（95% CI：2.011-36.19）。晚期肿瘤切除术与出血量更大（P =.03）和住院时间更长（P =.02）相关。联合手术与更高的颈动脉损伤发生率（P =.003）、残留肿瘤（P < .001）和更长的住院时间（P =.003）相关，因为这些联合手术通常用于晚期肿瘤（P =.02）。不同专业之间的结果没有差异。在 22 名外科医生中，每位外科医生的中位数手术次数为 1 次（范围=1-12，中位数 54.5%）。
仅完成 1 例 CBT 手术的外科医生的住院再入院率和住院时间更长。由于需要更复杂的手术，联合手术的结果更差，因为肿瘤更晚期。
4 级喉镜，131：E190-E195，2021。
