Surgical Specialties' Outcomes for Carotid Body Tumor Resection

ObjectiveThis study aimed to compare 30-day postoperative outcomes of carotid body tumor (CBT) resections performed by vascular surgeons vs otolaryngologists, examining complication rates, operation time, and hospital stay duration.MethodsA retrospective cohort analysis was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2006 to 2020. Patients undergoing CBT resection were identified using CPT code 60605. Only cases performed by vascular surgeons or otolaryngologists were included. The primary outcome was any major postoperative complication, with secondary outcomes including operation time and hospital length of stay. Multivariable logistic and linear regression models adjusted for confounders including age, sex, modified Charlson Comorbidity Index (mCCI), race, surgical setting, and emergency status.ResultsA total of 718 patients (545 vascular surgery, 173 otolaryngology) were included. Patients operated on by vascular surgeons were older (58 vs 51 years, p < .001), had a significantly higher incidence of hypertension (51% vs 36%; p < .001) and mCCI (1.78 ± 1.47 vs 1.25 ± 1.36; p < .001). Otolaryngology surgeries had significantly longer mean operative times (203 vs 145 min, p < .001) and a higher, though not statistically significant, rate of major complications (5.3% vs 2.3%, p = .07). Adjusted multivariable analysis showed otolaryngology specialty was independently associated with increased odds of severe adverse events (aOR: 2.99; 95% CI: 1.15-7.56; p = .021) and longer operation time (aβ: 61; 95% CI: 46-75; p < .001), but not with reoperation rates.ConclusionWhile both specialties achieved generally safe outcomes, CBT resections performed by otolaryngologists were associated with longer operative times and higher odds of major complications. These differences may reflect variations in case complexity, patient selection, or surgical expertise, warranting further prospective research into multidisciplinary and specialty-specific outcomes for CBT surgery.