Parotidectomy Trends Toward Outpatient for Benign Disease

Area of Science:

• Surgical Oncology
• Health Services Research

Background:

• Parotidectomy is a common surgical procedure for benign tumors.
• The trend towards outpatient surgery is increasing across various medical fields.

Purpose of the Study:

• To evaluate the safety and cost-effectiveness of outpatient parotidectomy.
• To identify factors influencing planned admission versus outpatient procedures.
• To analyze trends and outcomes associated with outpatient parotidectomy.

Main Methods:

• Retrospective cohort study conducted at a single tertiary academic center.
• Review of 370 parotidectomies for benign tumors between 2018 and 2023.
• Analysis of factors affecting admission status, operative approach, and surgical site.

Main Results:

• Outpatient parotidectomy demonstrated no significant difference in complications, readmissions, or recurrence compared to inpatient procedures.
• Factors decreasing the likelihood of outpatient procedures included longer travel time and total parotidectomy.
• Longer operative time increased the odds of switching to inpatient, while drain placement decreased the odds of outpatient status.
• A significant trend towards outpatient parotidectomy was observed post-COVID-19 declaration, with no increase in complications.
• Outpatient parotidectomy resulted in significant cost savings of $3838 per case compared to overnight admission.

Conclusions:

• Outpatient parotidectomy is a safe and viable option for patients with benign parotid tumors.
• The procedure is effective regardless of changes in admission status, surgical approach (superficial vs. total), or surgical site (ambulatory vs. hospital).
• Institutions can safely increase outpatient parotidectomy rates, leading to cost-effectiveness.