Cohen Oded, Hirsh Pnina, Winder Ophir, Hod Keren, Khafif Avi
A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Centers, Affiliated With Ben-Gurion University of the Negev, 20 HaBarzel Street, Tel Aviv, Israel.
Department of Otolaryngology Head and Neck Surgery, Soroka Medical Centers, Affiliated With Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Eur Arch Otorhinolaryngol. 2023 May;280(5):2489-2495. doi: 10.1007/s00405-022-07807-8. Epub 2023 Jan 11.
The safety of drainless lateral neck dissection (ND) remains to be proven. Hereby, we describe outcomes of drainless ND using fibrin sealant (FS).
A retrospective, single academic institute, matched cased control. The study group included patients who underwent drainless ND (drainless group), matched to control patients by age, sex, body mass index, laterality and median number of levels dissected. Additional comparison of patients who underwent at least II-IV lateral ND for a thyroid cancer indication was also conducted. Outcomes were post-operative seroma\infections.
A total of 118 patients (42 cases and 76 controls) were included in the study. Groups did not differ in pre-operative characteristics, percentage of bilateral ND, and extension of ND. No significant difference was found in terms of post-operative infections, seroma, aspirations, and post-operative antibiotic use. The additional analysis included 23 drainless lateral ND and matched controls, of which 91% underwent concomitant level V dissection. No significant difference was found in terms of post-operative seroma or infection. These findings were confirmed with a multivariate analysis.
Drainless ND using FS in non-violating mucosa surgeries appears to be feasible and safe, without significantly increasing post-operative seroma and its associated complications.
无引流侧颈清扫术(ND)的安全性仍有待证实。在此,我们描述使用纤维蛋白胶(FS)进行无引流ND的结果。
一项回顾性、单学术机构、匹配病例对照研究。研究组包括接受无引流ND的患者(无引流组),根据年龄、性别、体重指数、手术侧别和清扫淋巴结水平中位数与对照组患者进行匹配。还对因甲状腺癌指征接受至少II-IV级侧颈ND的患者进行了额外比较。观察指标为术后血清肿/感染情况。
本研究共纳入118例患者(42例病例组和76例对照组)。两组在术前特征、双侧ND的比例和ND范围方面无差异。在术后感染、血清肿、抽吸次数和术后抗生素使用方面未发现显著差异。额外分析包括23例无引流侧颈ND及其匹配对照组,其中91%的患者同时进行了V级清扫。在术后血清肿或感染方面未发现显著差异。多因素分析证实了这些结果。
在不侵犯黏膜的手术中使用FS进行无引流ND似乎是可行且安全的,不会显著增加术后血清肿及其相关并发症的发生。