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Outpatient Sistrunk procedure: A retrospective analysis.
Christopher Pool1, Mattie Rosi-Schumacher2, Christopher Ehret3
1Penn State Hershey Medical Center, Department of Otolaryngology - Head and Neck Surgery, USA.
International Journal of Pediatric Otorhinolaryngology
|November 6, 2020
Summary
Same day Sistrunk procedures are safe for select pediatric patients, with no significant difference in complication rates compared to overnight observation. Discharge decisions appear influenced by surgeon preference and drain placement, not patient safety outcomes.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Patient Safety
Background:
- Overnight observation after neck surgery is often based on risks like hematoma and airway compromise.
- The Sistrunk procedure is a common neck surgery in pediatric patients.
Purpose of the Study:
- To compare outcomes of pediatric patients undergoing the Sistrunk procedure with either same-day surgery discharge or overnight observation.
- To identify factors predicting overnight admission and associations with adverse events.
Main Methods:
- Retrospective review of 76 pediatric Sistrunk procedures (2008-2019).
- Bivariate and multivariable analyses assessed factors influencing overnight admission and adverse outcomes.
- Evaluated variables included ASA class, surgeon type, infection history, case recurrence, operation duration, pharyngeal violation, cyst rupture, cyst size, and drain placement.
Main Results:
- No life-threatening adverse events occurred in either group.
- Complication rates were similar: 17% for same-day discharge vs. 23% for overnight observation (p=0.47).
- Drain placement (OR 21.9) and otolaryngologist as surgeon (OR 11.7) strongly predicted overnight observation, independent of adverse events.
Conclusions:
- Same-day Sistrunk operations are safe for select healthy pediatric patients.
- Overnight observation is primarily associated with surgeon practice patterns (e.g., drain placement) rather than patient-specific adverse outcomes.
