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门诊与住院腮腺切除术的比较:系统评价和荟萃分析。

Outpatient vs inpatient parotidectomy: Systematic review and meta-analysis.

机构信息

Division of Otolaryngology - Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

Department of Otolaryngology - Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Head Neck. 2021 Feb;43(2):668-678. doi: 10.1002/hed.26482. Epub 2020 Oct 3.

Abstract

The primary aim of this study was to conduct a systematic review and meta-analysis to compare complications between outpatient vs inpatient parotidectomy. A systematic review was performed to identify patients undergoing either outpatient or inpatient partodiectomy, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, using PUBMED, SCOPUS, CINAHL, and the Cochrane library. Risk of bias was assessed using the Newcastle-Ottawa Scale. Postoperative complications (hematoma, seroma/sialocele, salivary fistula formation, Frey syndrome, surgical site infection [SSI]) were compared. Our search yielded 4958 nonduplicate articles, of which 13 studies were ultimately included (11 retrospective cohort, 2 prospective cohort), encompassing a total of 1323 patients (outpatient 46.33% vs inpatient 53.67%). There was no significant difference in total complications, hematoma, seroma, salivary fistula, or SSI rates between outpatient and inpatient groups. No significant difference in total complications was found between outpatient and inpatient groups when stratified by surgical approach (partial/superficial and total parotidectomy). Our findings suggest outpatient parotidectomy may be as safe as inpatient parotidectomy in appropriately selected patients.

摘要

本研究的主要目的是进行系统评价和荟萃分析,以比较门诊与住院腮腺切除术之间的并发症。根据系统评价和荟萃分析的首选报告项目,使用 PUBMED、SCOPUS、CINAHL 和 Cochrane 图书馆,对接受门诊或住院腮腺切除术的患者进行了系统评价。使用纽卡斯尔-渥太华量表评估偏倚风险。比较了术后并发症(血肿、血清肿/涎漏、涎瘘形成、Frey 综合征、手术部位感染 [SSI])。我们的检索产生了 4958 篇非重复文章,最终纳入了 13 项研究(11 项回顾性队列研究,2 项前瞻性队列研究),共纳入 1323 名患者(门诊 46.33%,住院 53.67%)。门诊组和住院组在总并发症、血肿、血清肿、涎瘘或 SSI 发生率方面无显著差异。当按手术方式(部分/浅表和全腮腺切除术)分层时,门诊组和住院组在总并发症方面也无显著差异。我们的研究结果表明,在适当选择的患者中,门诊腮腺切除术可能与住院腮腺切除术一样安全。

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