Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, MD.
Division of Vascular Surgery, Department of Surgery, University of Maryland, Baltimore, MD.
Ann Vasc Surg. 2024 Feb;99:442-447. doi: 10.1016/j.avsg.2023.09.080. Epub 2023 Oct 31.
Carotid body tumors (CBTs) are uncommon neuroendocrine tumors at the carotid bifurcation treated with resection. The goal of this study was to examine patient outcomes after CBT resection and establish predictors of morbidity.
Patients undergoing CBT resection were identified from the National Surgical Quality Improvement Program (NSQIP) database over 11 years. Demographics, past medical history, preoperative labs, procedural details, morbidity and mortality were recorded. Multivariable logistic regression (MLR) analysis was performed to determine independent predictors of morbidity.
From 2010 to 2020, 668 CBT resections were identified. The majority of patients were female (65%) and White (72%) with a mean age of 56 (standard deviation [SD] ± 16). Average body mass index (BMI) was 29.9 (SD ± 7.1). Arterial resection occurred in 81 patients (12%). 6% of patients experienced morbidity, most commonly re-operation (2.4%). Morbidity was more common in patients with higher BMI (33.1 vs. 29.7, P = 0.005), chronic obstruction pulmonary disease (10% vs. 1.9%, P = 0.012), higher American Society of Anesthesiologists (P = 0.005), and lower albumin (3.7 vs. 4, P = 0.016). Morbidity was not increased with arterial resection (P = 1) or based on length of operation (P = 0.169). Morbidity did not impact mortality (P = 0.06) though led to longer length of stay [LOS] (8 days vs. 2.4, P < 0.001). On MLR, preoperative BMI was the only risk factor for morbidity (odds ratio 1.06, 95% confidence interval 1.02-1.1, P = 0.005).
CBT resection is very well tolerated with low stroke rates, morbidity, and mortality. Arterial resection leads to increased transfusion requirements and LOS but did not increase stroke rates, mortality, or overall morbidity. Within the NSQIP database, preoperative BMI was the only predictor of postoperative morbidity, which leads to significantly longer LOS.
颈动脉体肿瘤（CBT）是发生在颈动脉分叉处的罕见神经内分泌肿瘤，通常采用切除术进行治疗。本研究旨在探讨 CBT 切除术后患者的转归，并确定发病率的预测因素。
从国家外科质量改进计划（NSQIP）数据库中检索了 11 年来接受 CBT 切除术的患者。记录了患者的人口统计学、既往病史、术前实验室检查、手术细节、发病率和死亡率。采用多变量逻辑回归（MLR）分析确定发病率的独立预测因素。
2010 年至 2020 年，共发现 668 例 CBT 切除术。大多数患者为女性（65%）和白人（72%），平均年龄为 56 岁（标准差[SD]±16 岁）。平均体重指数（BMI）为 29.9（SD±7.1）。81 例患者（12%）行动脉切除术。6%的患者出现并发症，最常见的是再次手术（2.4%）。BMI 较高的患者（33.1%比 29.7%，P=0.005）、慢性阻塞性肺疾病（10%比 1.9%，P=0.012）、美国麻醉医师协会（ASA）评分较高（P=0.005）和白蛋白水平较低（3.7 比 4，P=0.016）的患者发病率更高。动脉切除术（P=1）或手术时间（P=0.169）并不增加发病率。发病率虽不影响死亡率（P=0.06），但会导致住院时间延长[LOS]（8 天比 2.4 天，P<0.001）。多变量逻辑回归分析显示，术前 BMI 是发病率的唯一危险因素（比值比 1.06，95%置信区间 1.02-1.1，P=0.005）。
CBT 切除术耐受性良好，卒中发生率、发病率和死亡率均较低。动脉切除术虽增加了输血需求和 LOS，但并未增加卒中发生率、死亡率或总体发病率。在 NSQIP 数据库中，术前 BMI 是术后发病率的唯一预测因素，会显著延长 LOS。
