Postoperative Outcomes of Branchial Cleft Cyst Excision in Children and Adults: An NSQIP Analysis

2020 ◽  
Vol 162 (6) ◽  
pp. 959-968
Author(s):  
Annie E. Moroco ◽  
Robert A. Saadi ◽  
Vijay A. Patel ◽  
Erik B. Lehman ◽  
Meghan N. Wilson
Keyword(s):  
Postoperative Complications ◽  
Smoking Status ◽  
Pediatric Population ◽  
Branchial Cleft Cyst ◽  
Improvement Program ◽  
Cross Sectional ◽  
Perioperative Morbidity ◽  
Cyst Excision ◽  
Outpatient Procedures ◽  
Branchial Cleft

Objective Identify risk factors and perioperative morbidity for patients undergoing branchial cleft cyst (BCC) excision. Study Design Cross-sectional analysis. Setting American College of Surgeons National Surgical Quality Improvement Program adult and pediatric databases (NSQIP and NSQIP-P). Subject and Methods Patients who underwent BCC excision ( Current Procedural Terminology 42810, 42815) were queried via NSQIP (2005-2016) and NSQIP-P (2012-2016). Outcomes analyzed include patient demographics, medical comorbidities, admission type, operative characteristics, length of hospital stay, postoperative complications, and readmission. Results A total of 1775 children and 677 adults were identified. Mean age at time of surgery was 4.6 years for children and 38.6 years for adults. Outpatient procedures were performed in 87.1% of adults and 94.0% of children ( P < .001). Postoperative complications were uncommon, occurring in <1% of adults and 3.9% of children ( P < .001). Similarly, readmission occurred in 1.2% of adults and 1.1% of children. In adults, smoking status was shown to have a significant effect on postoperative complications (odds ratio, 6.25; P = .037). Age group did not have an effect on the complication rate in the pediatric population. Pediatric otolaryngologists had higher rates of postoperative complications ( P = .001), prolonged operative times ( P < .001), and fewer outpatient procedures ( P < .001). Conversely, in adults, otolaryngologists had fewer postoperative complications. Conclusion Postoperative complications following BCC excision are relatively uncommon, demonstrating procedural safety when performed at any age.

30-Day Postoperative Outcomes Following Transcervical Zenker’s Diverticulectomy in the Elderly: Analysis of the NSQIP Database

2020 ◽  
pp. 019459982097050
Author(s):  
Annie E. Moroco ◽  
Robert A. Saadi ◽  
Vijay A. Patel ◽  
Erik B. Lehman ◽  
John P. Gniady
Keyword(s):  
Postoperative Complications ◽  
Postoperative Complication ◽  
Odds Ratio ◽  
Smoking Status ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Postoperative Outcomes ◽  
Improvement Program ◽  
Cross Sectional ◽  
History Of

Objective To compare the effect of patient factors, including age, on 30-day postoperative outcomes and complications for patients undergoing transcervical Zenker’s diverticulectomy. Study Design Retrospective cross-sectional analysis. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Database. Methods Patients who underwent open Zenker’s diverticulectomy ( Current Procedural Terminology code 43130) were queried via the NSQIP (2006-2018). Outcomes analyzed include patient demographics, medical comorbidities, admission type, operative characteristics, length of admission, postoperative complication, readmission, and reoperation. Results A total of 614 patients were identified. Mean age at time of surgery was 71.1 years, with 13.4% older than 85 years. Outpatient procedures were performed in 29.8%. Postoperative complications occurred in 6.7%, with reoperation and readmission rates of 6.4% and 7.2%, respectively. A mortality rate of 0.3% was observed. Only smoking status (odds ratio, 2.94; P = .008) and history of congestive heart failure (odds ratio, 10.00; P = .014) were shown to have a significant effect on postoperative complications. Conclusion Smoking status confers a high risk for postoperative complication. Age was not an independent risk factor associated with adverse outcomes following open diverticulectomy, suggesting this procedure can be safely performed in patients with advanced age.

A cross-sectional evaluation of outcomes of pediatric branchial cleft cyst excision

2019 ◽  
Vol 119 ◽  
pp. 171-176
Author(s):  
Jillian Mattioni ◽  
Sarah Azari ◽  
Travis Hoover ◽  
Daniel Weaver ◽  
Sri Kiran Chennupati
Keyword(s):  
Branchial Cleft Cyst ◽  
Cross Sectional ◽  
Cyst Excision ◽  
Branchial Cleft

Congenital Diaphragmatic Hernia: Demographics and 30-day Outcomes in Adults

2020 ◽  
pp. 000313482096006
Author(s):  
Joseph G. Brungardt ◽  
Quinn A. Nix ◽  
Kurt P. Schropp
Keyword(s):  
Postoperative Complications ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pediatric Population ◽  
Case Series ◽  
National Database ◽  
Improvement Program ◽  
American College Of Surgeons ◽  
Postoperative Diagnosis ◽  
Acs Nsqip Database

Background Congenital diaphragmatic hernia (CDH) is a pathology most often affecting the pediatric population, although adults can also be affected. Few studies exist of adults undergoing repair of this defect. Using a national database, we sought to determine demographics and outcomes of this population. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with postoperative diagnosis of CDH, distinct from ventral hernia. Two groups were created based upon surgical approach of open or minimally invasive (MIS) repair. Baseline demographics and outcomes were compared. Results 110 patients undergoing surgical correction of CDH were captured in the database. We found rates of return to the operating room (4.55%), postoperative respiratory failure (5.45%), and reintubation (3.64%) with no difference between groups. There was no mortality and no difference between groups in length of operation, discharge to home, or postoperative complications. Patients undergoing open repair had a longer length of stay than patients in the MIS group (6.47 ± 10.76 days vs. 3.68 ± 3.74 days, P = .0471). Mesh was used in MIS more often than the open group (47.30% vs. 5.56%, P < .0001). Discussion This study describes rates of postoperative complications in patients undergoing repair of CDH, and suggests outcomes those are equivalent between patients receiving open or MIS approaches. Further case series or retrospective studies are needed to further describe this population of patients.

scholarly journals Hypoalbuminemia Is Associated With Increased Postoperative Mortality and Complications in Hand Surgery

Hand ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 547-555 ◽  
Author(s):  
Timothy J. Luchetti ◽  
Andrew Chung ◽  
Neil Olmscheid ◽  
Daniel D. Bohl ◽  
Joshua W. Hustedt
Keyword(s):  
Serum Albumin ◽  
Smoking Status ◽  
Postoperative Mortality ◽  
Hand Surgery ◽  
Normal Serum ◽  
Morbidity And Mortality ◽  
Improvement Program ◽  
Perioperative Morbidity ◽  
Increased Risk ◽  
Stage Renal Disease

Background: Malnutrition has been associated with increased perioperative morbidity and mortality in orthopedic surgery. This study was designed with the hypothesis that preoperative hypoalbuminemia, a marker for malnutrition, is associated with increased complications after hand surgery. Methods: A retrospective cohort study of 208 hand-specific Current Procedural Terminology codes was conducted with the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013. In all, 629 patients with low serum albumin were compared with 4079 patients with normal serum albumin. The effect of hypoalbuminemia was tested for association with 30-day postoperative mortality, and major and minor complications. Results: Hypoalbuminemia was independently associated with emergency surgery, diabetes mellitus, dependent functional status, hypertension, end-stage renal disease, current smoking status, and anemia. Patients with hypoalbuminemia had a higher rate of mortality, minor complications, and major complications. Conclusions: Hypoalbuminemia is associated with an increased risk of postoperative morbidity and mortality in patients undergoing hand surgery. As such, increased focus on perioperative nutrition optimization may lead to improved outcomes for patients undergoing hand surgery.

Branchial Cleft Cyst Excision

2011 ◽  
pp. 128-132
Author(s):  
James I. Cohen ◽  
Markus Gapany ◽  
Henry A. Milczuk ◽  
Mark K. Wax
Keyword(s):  
Branchial Cleft Cyst ◽  
Cyst Excision ◽  
Branchial Cleft

scholarly journals Outcomes of pediatric thyroidectomy: a cross-sectional evaluation

2020 ◽  
Vol 3 (4) ◽  
pp. e000185
Author(s):  
Sarah Azari ◽  
Jackson Randolph ◽  
Harry Shi ◽  
Travis Hoover ◽  
Daniel Weaver ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pediatric Population ◽  
Surgical Site Infections ◽  
Improvement Program ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Surgical Quality ◽  
Thyroid Lobectomy ◽  
Sectional Analysis ◽  
The Relationship

IntroductionPediatric thyroidectomy is performed by a variety of surgical specialties. Thyroidectomy can result in a number of complications. Previous studies cite that the most common complications in children are pain and transient hypocalcemia. The purposes of this report are to assess the adverse events of thyroidectomies performed in the pediatric population and to assess the relationship between surgical specialties and postoperative thyroidectomy complications.MethodsWe conducted a cross-sectional analysis of cases from January 1, 2014 through November 1, 2015 using the National Surgical Quality Improvement Program database for patients undergoing excision of cyst or adenoma of the thyroid, unilateral thyroid lobectomy, or total thyroidectomy.ResultsOf the 344 patients who underwent thyroidectomy, 10 (2.9%) experienced at least one complication. The most common complications were readmission, surgical site infections, and wound disruption. There was a statistically significant association between complication incidence and surgical specialty (p=0.006). Pediatric otolaryngology had a statistically significantly higher number of complications than pediatric surgery (p<0.008).ConclusionOverall, the incidence of adverse events following pediatric thyroidectomy was low.

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

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