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Abstract：
OBJECTIVE: Sialocele and salivary fistula are recognised complications of parotid surgery and have been reported to be more common with less extensive parotidectomy. We investigated the efficacy of tissue sealant(Cunniffe et al., 2019) 1 as an alternative to surgical drainage in terms of length of hospital stay (LOS), cost, and incidence of wound complications.
METHODS: The study comprised a retrospective review of a prospectively maintained parotidectomy database at a single tertiary Head and Neck referral centre between 2009 and 2020. Cases undergoing concomitant neck dissection or major skin resection were excluded. Patients were divided into Group 1 (without tissue sealant), and Group 2 (with tissue sealant). Patients were also divided based on extent of surgery 1) Extracapsular dissection/Partial superficial parotidectomy 2) Superficial/total parotidectomy.
RESULTS: Of 202 included patients, there were 146 in Group 1 (143 with drain), and 56 in Group 2 (7 with drain). Compared to Group 1, Group 2 had a significantly shorter LOS (mean 1.4 ± 0.98 versus 3.1 ± 1.29 days, p < 0.05) and estimated cost (€1386 versus €2736). There was no significant difference in the complication rates (15.8% Group 1 versus 10.7% Group 2, p = 0.50). Group 1 showed a higher incidence of complications in patients undergoing less extensive parotidectomy (19/70 versus 4/76, p = 0.02), whereas in Group 2, the difference was not significant (5/30 versus 1/26, p = 0.20).
CONCLUSIONS: The use of tissue sealant as an alternative to surgical drains after parotidectomy facilitates reduced LOS and cost savings without increase in morbidity.
METHODS: 3.
METHODS: The study comprised a retrospective review of a prospectively maintained parotidectomy database at a single tertiary Head and Neck referral centre between 2009 and 2020. Cases undergoing concomitant neck dissection or major skin resection were excluded. Patients were divided into Group 1 (without tissue sealant), and Group 2 (with tissue sealant). Patients were also divided based on extent of surgery 1) Extracapsular dissection/Partial superficial parotidectomy 2) Superficial/total parotidectomy.
RESULTS: Of 202 included patients, there were 146 in Group 1 (143 with drain), and 56 in Group 2 (7 with drain). Compared to Group 1, Group 2 had a significantly shorter LOS (mean 1.4 ± 0.98 versus 3.1 ± 1.29 days, p < 0.05) and estimated cost (€1386 versus €2736). There was no significant difference in the complication rates (15.8% Group 1 versus 10.7% Group 2, p = 0.50). Group 1 showed a higher incidence of complications in patients undergoing less extensive parotidectomy (19/70 versus 4/76, p = 0.02), whereas in Group 2, the difference was not significant (5/30 versus 1/26, p = 0.20).
CONCLUSIONS: The use of tissue sealant as an alternative to surgical drains after parotidectomy facilitates reduced LOS and cost savings without increase in morbidity.
METHODS: 3.
摘要：
目的：唾液腺膨出和唾液瘘是公认的腮腺手术并发症，据报道，腮腺切除术较少，更常见。我们调查了组织密封剂的功效(Cunniffe等人。,2019）1在住院时间（LOS）方面作为手术引流的替代方案，成本,伤口并发症的发生率。
方法：该研究包括对2009年至2020年在一个三级头颈部转诊中心进行的前瞻性维护的腮腺切除术数据库的回顾性回顾。排除同时行颈部清扫术或大范围皮肤切除术的病例。患者分为第1组（无组织密封剂），和第2组(用组织密封剂)。还根据手术范围对患者进行了划分1）囊外解剖/部分浅表腮腺切除术2）浅表/全腮腺切除术。
结果：在202名患者中，第一组有146个(143个有排水沟)，和第2组中的56（带排水管的7）。与第1组相比，第2组的LOS明显较短（平均1.4±0.98天对3.1±1.29天，p<0.05）和估计成本（1386欧元对2736欧元）。并发症发生率没有显着差异（第1组15.8%对第2组10.7%，p=0.50）。第1组患者行广泛腮腺切除术的并发症发生率较高（19/70对4/76，p=0.02），而在第2组中,差异不显著(5/30对1/26,p=0.20).
结论：腮腺切除术后使用组织密封胶替代手术引流有助于减少LOS和节约成本而不增加发病率。
方法：3.
方法：该研究包括对2009年至2020年在一个三级头颈部转诊中心进行的前瞻性维护的腮腺切除术数据库的回顾性回顾。排除同时行颈部清扫术或大范围皮肤切除术的病例。患者分为第1组（无组织密封剂），和第2组(用组织密封剂)。还根据手术范围对患者进行了划分1）囊外解剖/部分浅表腮腺切除术2）浅表/全腮腺切除术。
结果：在202名患者中，第一组有146个(143个有排水沟)，和第2组中的56（带排水管的7）。与第1组相比，第2组的LOS明显较短（平均1.4±0.98天对3.1±1.29天，p<0.05）和估计成本（1386欧元对2736欧元）。并发症发生率没有显着差异（第1组15.8%对第2组10.7%，p=0.50）。第1组患者行广泛腮腺切除术的并发症发生率较高（19/70对4/76，p=0.02），而在第2组中,差异不显著(5/30对1/26,p=0.20).
结论：腮腺切除术后使用组织密封胶替代手术引流有助于减少LOS和节约成本而不增加发病率。
方法：3.
