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颈侧区清扫术中使用纤维蛋白封闭剂的相关结果。

Outcomes Associated With Fibrin Sealant Use in Lateral Neck Dissections.

作者信息

Stanisce Luke, Lai Michael, Ahmad Nadir, Spalla Thomas C, Reid Lisa M, Gaughan John P, Koshkareva Yekaterina

机构信息

Division of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, USA.

Cooper Medical School, Rowan University, Camden, New Jersey, USA.

出版信息

OTO Open. 2020 Dec 28;4(4):2473974X20981021. doi: 10.1177/2473974X20981021. eCollection 2020 Oct-Dec.

Abstract

OBJECTIVE

To determine whether the use of fibrin sealant tissue adhesives during lateral neck dissections is associated with a change in postoperative outcomes.

STUDY DESIGN

Retrospective cohort.

SETTING

Institutionally affiliated tertiary care center.

METHODS

Various demographic, disease, and surgical data were collected for patients who underwent lateral neck dissections. Univariate regression analysis was performed with the following outcomes: total drain output and duration of drain placement, as well as incidence of postoperative infection, hematoma, seroma, chyle leak, and salivary leak.

RESULTS

A total of 133 patients underwent lateral neck dissections. Fibrin sealant was used in 35% of cases (n = 46). Its use was not associated with differences in total drain output ( = .77) or the number of days that the drains were in place ( = .83). On secondary analysis, the use of fibrin sealant was not associated with a difference in postoperative incidence of hematoma ( = .65), seroma ( = .68), chyle leak ( = .42), or salivary leak ( = .73). These results were consistent when stratified by the presence of intraoperative complications. Its use accompanied an average cost of $674 per case.

CONCLUSIONS

Fibrin sealant use during lateral neck dissections was not associated with a reduction in drain output or days that the drains remained in situ. Although the current study was limited by sample size, fibrin sealant use was not associated with a decreased risk of postoperative adverse events. The evidence in this report suggests that the routine use of these products adds cost without clear benefit.

摘要

目的

确定在侧颈清扫术中使用纤维蛋白封闭剂组织粘合剂是否会导致术后结果的改变。

研究设计

回顾性队列研究。

研究地点

机构附属三级护理中心。

方法

收集接受侧颈清扫术患者的各种人口统计学、疾病和手术数据。对以下结果进行单因素回归分析:总引流量和引流管放置时间,以及术后感染、血肿、血清肿、乳糜漏和涎漏的发生率。

结果

共有133例患者接受了侧颈清扫术。35%的病例(n = 46)使用了纤维蛋白封闭剂。其使用与总引流量(P = 0.77)或引流管放置天数(P = 0.83)的差异无关。在二次分析中,纤维蛋白封闭剂的使用与术后血肿发生率(P = 0.65)、血清肿发生率(P = 0.68)、乳糜漏发生率(P = 0.42)或涎漏发生率(P = 0.73)的差异无关。按术中并发症的存在情况分层时,这些结果是一致的。其使用每例平均成本为674美元。

结论

在侧颈清扫术中使用纤维蛋白封闭剂与引流量减少或引流管留置天数减少无关。尽管本研究受样本量限制,但纤维蛋白封闭剂的使用与术后不良事件风险降低无关。本报告中的证据表明,常规使用这些产品会增加成本且无明显益处。

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