Asghar Muaaz, Pang Kenny, Asghar Mauz, Rotenberg Brian
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Asia Sleep Centre, Singapore, Singapore.
PLoS One. 2025 Jul 7;20(7):e0326704. doi: 10.1371/journal.pone.0326704. eCollection 2025.
The systematic review aims to determine the safety of conducting non-upper airway surgery in an ambulatory surgery center (ASC) for OSA patients.
A comprehensive search was conducted from MEDLINE, Embase, CENTRAL, and Scopus from inception through February 2023.
Studies including non-upper airway surgery done in ASC settings were identified. Risk of bias was assessed using the Murad Tool and Newcastle-Ottawa scale. Primary outcomes were 24 hour complications and unplanned admission rates.
From 9313 studies, 13 non-OSA studies with 31,200 OSA participants and 318,709 non-OSA participants were identified. Severe complications were rare and tended to occur within the first 4 hours of the postoperative period. While a majority of smaller scale studies found no significant difference in unplanned admissions, large scale studies with multivariate analysis find OSA to be an independent risk factor for unplanned admission and 30-day complications. However, large scale ASC studies have found that with proper selection and perioperative interventions, OSA patients can undergo outpatient surgery at ASCs safely.
OSA patients with mild or controlled comorbidities can safely undergo ambulatory non-OSA surgery in ASCs.
The protocol for this review was registered with the PROSPERO database (Registration number: CRD42023415162).
本系统评价旨在确定在门诊手术中心（ASC）为阻塞性睡眠呼吸暂停（OSA）患者进行非上呼吸道手术的安全性。
从MEDLINE、Embase、CENTRAL和Scopus数据库自创建至2023年2月进行了全面检索。
纳入在ASC环境中进行的非上呼吸道手术的研究。使用穆拉德工具和纽卡斯尔-渥太华量表评估偏倚风险。主要结局为24小时并发症和非计划住院率。
从9313项研究中，识别出13项非OSA研究，其中有31200名OSA参与者和318709名非OSA参与者。严重并发症罕见，且往往发生在术后最初4小时内。虽然大多数小规模研究发现非计划住院率无显著差异，但进行多变量分析的大规模研究发现OSA是导致非计划住院和30天并发症的独立危险因素。然而，大规模ASC研究发现，通过适当的选择和围手术期干预，OSA患者可以在ASC安全地接受门诊手术。
合并症轻度或得到控制的OSA患者可以在ASC安全地接受非OSA门诊手术。
本综述方案已在PROSPERO数据库注册（注册号：CRD42023415162）。
