Outpatient vs inpatient parotidectomy: A systematic review and meta-analysis

Outpatient parotidectomy has emerged as a potential alternative to inpatient surgery for selected patients. This systematic review and meta-analysis aimed to compare postoperative complications between outpatient and inpatient parotidectomy. A systematic search was conducted across PubMed/MedLine, Scopus, Web of Science, CENTRAL, and Google Scholar up to October 12, 2025. Observational and interventional studies comparing outpatient and inpatient parotidectomy in adults were included. Quality of studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects model. Heterogeneity was quantified using I², and certainty of evidence was rated using the GRADE framework. Ten retrospective cohort studies were included. Outpatient surgery was associated with significantly lower odds of hematoma (0.36, 95 % CI: 0.17-0.77), permanent facial nerve weakness (OR = 0.10, 95 % CI: 0.06-0.17), and reoperation (OR = 0.32, 95 % CI: 0.23-0.44). No significant differences were observed for seroma, sialocele, infection, Frey's syndrome, fistula, or transient facial nerve weakness. All included studies were of moderate methodological quality, and the overall certainty of evidence was very low. Outpatient parotidectomy appears safe and feasible for selected patients, with complication rates comparable to inpatient surgery. Further prospective studies are needed to confirm these findings.