Khan Daniyal A, Farooq Ayesha, Jiwani Uswa, Ahsan Muhammad Asif, Shahzad Farooq, Rahman Mohammad Fazlur
Department of Surgery, Aga Khan University, Karachi, Pakistan.
Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Plast Surg (Oakv). 2021 Feb;29(1):10-15. doi: 10.1177/2292550320935969. Epub 2020 Jun 30.
Cleft palate repair is considered to be a safe procedure, yet still carries a 5% to 30% risk of complications. This study sought to assess the outcomes of this procedure in a high-burden Asian country that partners with the Smile Train to perform cleft surgeries.
The Aga Khan University medical records database was queried for pediatric patients undergoing cleft surgery between 2014 and 2017. Data were abstracted from the patient medical records, and details of the clinical, demographic factors, and postoperative outcomes were assessed.
Among 142 patients with orofacial clefts, 102 (72%) underwent primary cleft palate repair, one-third (n = 36, 35%) of whom were operated as part of the Smile Train. The median preoperative hemoglobin was 11.4 g/dL (interquartile range: 10.7-12.0 g/dL), whereas the median weight was 8.3 kg (7.7-11.4 kg). Nearly two-thirds (n = 64, 63%) of the cohort underwent preoperative cardiology screening, with only a minority undergoing orthodontic treatment (n = 6, 6%). Approximately 15% (n = 15) of patients experienced a postoperative complication, most often a fistula (n = 11, 73%). On multivariable analysis, with each unit increase in hemoglobin levels, there was a 50% reduction in the odds of experiencing a complication (odds ratio: 0.51, 95% CI: 0.28-0.87). There were no in-patient deaths among the cohort.
The results of the current study provide useful information to key stakeholders including patients, plastic surgeons, and policy makers on the outcomes of cleft palate repair in a developing country.
腭裂修复术被认为是一种安全的手术，但仍有5%至30%的并发症风险。本研究旨在评估在一个与“微笑列车”合作开展腭裂手术的高负担亚洲国家中该手术的效果。
查询阿迦汗大学2014年至2017年间接受腭裂手术的儿科患者的医疗记录数据库。从患者医疗记录中提取数据，并评估临床、人口统计学因素及术后结果的详细信息。
在142例口面部裂患者中，102例（72%）接受了初次腭裂修复术，其中三分之一（n = 36，35%）是作为“微笑列车”项目的一部分进行手术的。术前血红蛋白中位数为11.4 g/dL（四分位间距：10.7 - 12.0 g/dL），而体重中位数为8.3 kg（7.7 - 11.4 kg）。近三分之二（n = 64，63%）的队列患者接受了术前心脏科筛查，只有少数患者接受了正畸治疗（n = 6，6%）。约15%（n = 15）的患者出现术后并发症，最常见的是瘘管（n = 11，73%）。多变量分析显示，血红蛋白水平每增加一个单位，发生并发症的几率降低50%（比值比：0.51，95%置信区间：0.28 - 0.87）。该队列中无住院死亡病例。
本研究结果为包括患者、整形外科医生和政策制定者在内的关键利益相关者提供了关于发展中国家腭裂修复术效果的有用信息。
