Outpatient (same-day discharge) versus inpatient parotidectomy: A systematic review and meta-analysis.
Journal
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
ISSN: 1749-4486
Titre abrégé: Clin Otolaryngol
Pays: England
ID NLM: 101247023
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
15
11
2019
revised:
13
12
2019
accepted:
15
01
2020
pubmed:
28
2
2020
medline:
24
8
2021
entrez:
28
2
2020
Statut:
ppublish
Résumé
Parotidectomy is often performed as an inpatient procedure largely due to drain insertion; however, outpatient parotidectomy has increasingly become an attractive alternative for its shorter hospital stays and greater efficiency in cost-effectiveness. To assess the safety and feasibility of outpatient (or same-day discharge) parotidectomy compared with inpatient parotidectomy. Systematic review of the literature and meta-analysis, in accordance with the PRISMA guidelines. Pubmed/Medline, Embase, CINAHL, Google Scholar, Web of Science, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles published in English between 01/01/1990 and 05/10/2019. The Newcastle-Ottawa Scale was used for quality assessment and Review Manager 5.3 for meta-analyses. Primary outcomes assessed were postoperative complications including bleeding/haematoma, surgical site infection, seroma and facial weakness. Secondary outcome was readmission rate. Out of 445 studies identified, 6 were selected for systematic review. The overall quality of evidence was moderate. A total of 3664 patients were included (1646 in the outpatient group and 2018 in the inpatient group). Comparing the outpatient with inpatient cohorts, there were lower complications in outpatient groups though not statistically significant for haematoma (OR = 0.45; 95% CI = 0.11-1.92; P = .28), surgical site infection (OR = 0.88; 95% CI = 0.46-1.69; P = .70), seroma (0.79; 95% CI = 0.21-3.03; P = .74), facial nerve weakness (OR 0.39; 95% CI = 0.14-1.08; P = .07) and hospital readmission (OR 0.58; 95% CI = 0.33-1.04; P = .07). Outpatient parotidectomy appears to be safe and compares favourably to inpatient procedure in postoperative complication and readmission rates.
Sections du résumé
BACKGROUND
Parotidectomy is often performed as an inpatient procedure largely due to drain insertion; however, outpatient parotidectomy has increasingly become an attractive alternative for its shorter hospital stays and greater efficiency in cost-effectiveness.
OBJECTIVE OF REVIEW
To assess the safety and feasibility of outpatient (or same-day discharge) parotidectomy compared with inpatient parotidectomy.
TYPE OF REVIEW
Systematic review of the literature and meta-analysis, in accordance with the PRISMA guidelines.
METHODS
Pubmed/Medline, Embase, CINAHL, Google Scholar, Web of Science, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles published in English between 01/01/1990 and 05/10/2019. The Newcastle-Ottawa Scale was used for quality assessment and Review Manager 5.3 for meta-analyses.
MAIN OUTCOME MEASURES
Primary outcomes assessed were postoperative complications including bleeding/haematoma, surgical site infection, seroma and facial weakness. Secondary outcome was readmission rate.
RESULTS
Out of 445 studies identified, 6 were selected for systematic review. The overall quality of evidence was moderate. A total of 3664 patients were included (1646 in the outpatient group and 2018 in the inpatient group). Comparing the outpatient with inpatient cohorts, there were lower complications in outpatient groups though not statistically significant for haematoma (OR = 0.45; 95% CI = 0.11-1.92; P = .28), surgical site infection (OR = 0.88; 95% CI = 0.46-1.69; P = .70), seroma (0.79; 95% CI = 0.21-3.03; P = .74), facial nerve weakness (OR 0.39; 95% CI = 0.14-1.08; P = .07) and hospital readmission (OR 0.58; 95% CI = 0.33-1.04; P = .07).
CONCLUSIONS
Outpatient parotidectomy appears to be safe and compares favourably to inpatient procedure in postoperative complication and readmission rates.
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
529-537Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Nouraei S, Ismail Y, Ferguson M, et al. Analysis of complications following surgical treatment of benign parotid disease. ANZ J Surg. 2008;78(3):134-138.
de Boisanger L, Blackwell N, Magos T, Adamson R, Hilmi O. Day case hemithyroidectomy is safe and feasible: experience in Scotland. Scottish Med J. 2015;60(4):239-243.
Snyder S, Hamid K, Roberson C, et al. Outpatient thyroidectomy is safe and reasonable: experience with more than 1,000 planned outpatient procedures. J Am Coll Surg. 2010;210(5):575-582.
Mortuaire G, Theis D, Fackeure R, Chevalier D, Gengler I. Cost-effectiveness assessment in outpatient sinonasal surgery. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(1):11-15.
Wijayasingam G, Deutsch P, Jindal M. Day case adenotonsillectomy for paediatric obstructive sleep apnoea: a review of the evidence. Eur Arch Otorhinolaryngol. 2018;275(9):2203-2208.
Maharaj M, Diamond C, Williams D, Seikaly H, Harris J. Tisseel to reduce postparotidectomy wound drainage: randomized, prospective, controlled trial. J Otolaryngol. 2006;35(01):36.
Mofle P, Urquhart A. Superficial parotidectomy and postoperative drainage. Clin Med Res. 2008;6(2):68-71.
Amir I, Morar P, Belloso A. Postoperative drainage in head and neck surgery. Ann R Coll Surg Engl. 2010;92(8):651-654.
Byers R, Ballantyne A, Goepfert H, Guillamondegui O, Larson D, Medina J. Clinical effects of closed suction drainage on wound healing in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 1982;108(11):723-726.
Klintworth N, Zenk J, Koch M, Iro H. Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function. Laryngoscope. 2010;120(3):484-490.
Dulguerov P, Quinodoz D, Cosendai G, Piletta P, Marchal F, Lehmann W. Prevention of Frey Syndrome During Parotidectomy. Arch Otolaryngol Head Neck Surg. 1999;125(8):833.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535-b2535.
Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Alessandro L, et al. The Oxford Levels of Evidence. 2016;2: https://www.cebm.net/2016/05/ocebm-levels-of-evidence/
Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. 2019 [cited 2019 Oct 3]. pp. 1-4. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
Steckler R. Outpatient parotidectomy. Am J Surg. 1991;162(4):303-305.
Coniglio A, Deal A, Hackman T. Outcomes of drainless outpatient parotidectomy. Head Neck. 2019;41(7):2154-2158.
Ziegler A, Lazzara G, Thorpe E. Safety and Efficacy of Outpatient Parotidectomy. J Oral Maxillofac Surg. 2018;76(11):2433-2436.
Van Horn A, Goldman R, Charnigo R, Johnson K, Valentino J, Aouad R. Outpatient versus observation/inpatient parotidectomy: patient factors and perioperative complications. Eur Arch Otorhinolaryngol. 2017;274(9):3437-3442.
Bentkover S, Kozlicak B, Girouard S. Outpatient parotidectomy at the fallon clinic: the first 2 years. Arch Otolaryngol Head Neck Surg. 1996;122(10):1049-1053.
Siddiqui S, Singh R, Siddiqui E, et al. Outpatient versus inpatient parotidectomy: Comparison of postoperative complication rates. Laryngoscope. 2018;129(3):655-661.
Woods R, Woods J, Duignan E, Timon C. Systematic review and meta-analysis of wound drains after thyroid surgery. Br J Surg. 2014;101(5):446-456.
Bajwa M, Tudur-Smith C, Shaw R, Schache A. Fibrin sealants in soft tissue surgery of the head and neck: A systematic review and meta-analysis of randomised controlled trials. Clin Otolaryngol. 2017;42(6):1141-1152.
Conboy P, Brown DH. Use of tissue sealant for day surgery parotidectomy. J Otolaryngol Head Neck Surg. 2008;37:208-211.
Ujam A, Awad Z, Wong G, Tatla T, Farrell R. Safety trial of Floseal® haemostatic agent in head and neck surgery. Ann R Coll Surg Engl. 2012;94(5):336-339.
Bannister M, Ah-See K. Safety of the haemostatic agent Surgiflo® in excisions of the submandibular gland: our experience in 17 cases. Br J Oral Maxillofac Surg. 2014;52(9):e134-e135.