Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Abstract Objectives Thyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure,...

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Main Authors: Erin M. Wynings, Cynthia S. Wang, Shyon Parsa, Romaine F. Johnson, Christopher C. Liu
Format: Article
Language:English
Published: Wiley 2023-12-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.1183
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author Erin M. Wynings
Cynthia S. Wang
Shyon Parsa
Romaine F. Johnson
Christopher C. Liu
author_facet Erin M. Wynings
Cynthia S. Wang
Shyon Parsa
Romaine F. Johnson
Christopher C. Liu
author_sort Erin M. Wynings
collection DOAJ
description Abstract Objectives Thyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence. Methods This was a retrospective case series of pediatric patients undergoing the Sistrunk procedure from June 2009 to April 2021. Results A total of 273 patients were included. Of these, 139 (53%) patients were male and 181 (66%) were white. The average age at the time of surgery was 7.1 years. The overall cyst recurrence rate was 11%. The most common wound complications were seroma (14%) and surgical site infections (SSIs) (12%). Wound complications were associated with prior history of cyst infection (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.07–3.60, z‐test 2.2, p = .03). Pediatric surgery was associated with fewer wound complications (OR 0.18; 95% CI 0.05–0.6, z‐test −2.78, p = .005). However, pediatric surgery operated on fewer patients with a history of cyst infection (36% vs. 55%, p = .012). Drain placement and postoperative antibiotics did not affect rates of wound complications. Conclusions Prior cyst infection is associated with increased rates of postoperative wound complications. Postoperative antibiotics and drain placement did not significantly affect complication rates. Level of Evidence 4.
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spelling doaj.art-7508af7d01fb463989c0ca7dc24b1ce92023-12-20T09:48:34ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-12-01861571157810.1002/lio2.1183Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedureErin M. Wynings0Cynthia S. Wang1Shyon Parsa2Romaine F. Johnson3Christopher C. Liu4Department of Otolaryngology—Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology—Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology—Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology—Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology—Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USAAbstract Objectives Thyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence. Methods This was a retrospective case series of pediatric patients undergoing the Sistrunk procedure from June 2009 to April 2021. Results A total of 273 patients were included. Of these, 139 (53%) patients were male and 181 (66%) were white. The average age at the time of surgery was 7.1 years. The overall cyst recurrence rate was 11%. The most common wound complications were seroma (14%) and surgical site infections (SSIs) (12%). Wound complications were associated with prior history of cyst infection (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.07–3.60, z‐test 2.2, p = .03). Pediatric surgery was associated with fewer wound complications (OR 0.18; 95% CI 0.05–0.6, z‐test −2.78, p = .005). However, pediatric surgery operated on fewer patients with a history of cyst infection (36% vs. 55%, p = .012). Drain placement and postoperative antibiotics did not affect rates of wound complications. Conclusions Prior cyst infection is associated with increased rates of postoperative wound complications. Postoperative antibiotics and drain placement did not significantly affect complication rates. Level of Evidence 4.https://doi.org/10.1002/lio2.1183postoperative complicationsrecurrenceSistrunk procedurethyroglossal duct cyst
spellingShingle Erin M. Wynings
Cynthia S. Wang
Shyon Parsa
Romaine F. Johnson
Christopher C. Liu
Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
Laryngoscope Investigative Otolaryngology
postoperative complications
recurrence
Sistrunk procedure
thyroglossal duct cyst
title Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
title_full Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
title_fullStr Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
title_full_unstemmed Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
title_short Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure
title_sort risk adjusted analysis of perioperative outcomes after the sistrunk procedure
topic postoperative complications
recurrence
Sistrunk procedure
thyroglossal duct cyst
url https://doi.org/10.1002/lio2.1183
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AT shyonparsa riskadjustedanalysisofperioperativeoutcomesafterthesistrunkprocedure
AT romainefjohnson riskadjustedanalysisofperioperativeoutcomesafterthesistrunkprocedure
AT christophercliu riskadjustedanalysisofperioperativeoutcomesafterthesistrunkprocedure