Department of Otolaryngology- Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Otolaryngology-Head and Neck Surgery, George Washington University, Children's National Medical Center, Washington, DC, USA.
Ann Otol Rhinol Laryngol. 2021 Sep;130(9):1052-1056. doi: 10.1177/0003489421990161. Epub 2021 Feb 10.
The objective of this study was to compare complications and other perioperative outcomes between intraoral and transcervical drainage of both retropharyngeal and parapharyngeal abscesses.
This was a retrospective study that analyzed data from the 2012 to 2016 National Surgical Quality Improvement Program (NSQIP)-Pediatric public use files. Baseline characteristics and perioperative outcomes including postoperative complications and length of hospital stay (LOS) were compared between intraoral and transcervical drainage groups. Multivariable logistic regression was performed to inspect predictors of having an extended LOS, defined as LOS greater than 3 days.
A total of 1174 patients were included. Mean age was 5.1 ± 3.8 years in the intraoral group (N = 1063) and 4.2 ± 4.3 years in the transcervical group (N = 111, < .001). There was no significant difference in the rate of post-operative complications between groups (5.7% intraoral vs 8.1% transcervical, = .316). LOS was significantly longer in the transcervical group (>3 days in 36.2% of intraoral vs 49.5% of transcervical, = .006). Patients in the transcervical group had 1.59 times the odds of extended LOS, after adjusting for age, pre-operative ventilator support, asthma, structural pulmonary disease, hematologic disorders, and all post-operative complications ( = .024).
There does not appear to be a significant difference in the rate of post-operative complications after intraoral versus transcervical drainage for pharyngeal abscesses in children. However, transcervical drainage was associated with an extended hospital stay. Further prospective studies will be needed to determine the reasons for this.
本研究的目的是比较口内和经颈引流治疗咽后和咽旁脓肿的并发症和其他围手术期结果。
这是一项回顾性研究，分析了 2012 年至 2016 年国家手术质量改进计划（NSQIP-儿科）公共使用文件中的数据。比较了口内组和经颈组的基本特征和围手术期结果，包括术后并发症和住院时间（LOS）。采用多变量逻辑回归分析延长 LOS（定义为 LOS 大于 3 天）的预测因素。
共纳入 1174 例患者。口内组（N=1063）平均年龄为 5.1±3.8 岁，经颈组（N=111）平均年龄为 4.2±4.3 岁（<0.001）。两组术后并发症发生率无显著差异（口内组 5.7%，经颈组 8.1%，=0.316）。经颈组 LOS 明显较长（口内组>3 天的患者占 36.2%，经颈组占 49.5%，=0.006）。调整年龄、术前呼吸机支持、哮喘、结构性肺病、血液系统疾病和所有术后并发症后，经颈组患者延长 LOS 的可能性是口内组的 1.59 倍（=0.024）。
儿童咽后和咽旁脓肿口内与经颈引流后，术后并发症发生率无显著差异。然而，经颈引流与住院时间延长有关。需要进一步的前瞻性研究来确定原因。
