Extracapsular Dissection Versus Superficial Parotidectomy: A Systematic Review and Meta-Analysis of Perioperative Efficiency.

ImportancePerioperative efficiency is an increasingly important consideration in head and neck surgery, yet comparative evaluations of surgical techniques for benign parotid tumors remain limited.ObjectiveTo evaluate the perioperative efficiency of extracapsular dissection (ECD) compared to superficial parotidectomy (SP) for benign parotid tumors.DesignSystematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.SettingStudies retrieved from PubMed, Embase, and the Cochrane Library.ParticipantsPatients with benign parotid tumors who underwent either ECD or SP. Fifteen studies encompassing 2399 patients were included.InterventionsECD and SP as primary surgical techniques for the removal of benign parotid tumors.Main Outcome MeasuresParameters related to perioperative efficiency were defined in this study as operative time, anesthesia time, duration of drain placement, length of hospital stay (LOS), and medical costs. Tumor size was also included as a comparative parameter.ResultsECD was associated with significantly shorter operative time [mean difference (MD), -48.95 minutes; 95% confidence interval (CI), -66.40 to -31.50], anesthesia time (MD, -73.17 minutes; 95% CI, -81.61 to -64.73), drain placement duration (MD, -2.10 days; 95% CI, -3.82 to -0.38), and LOS (MD, -0.91 days; 95% CI, -1.34 to -0.48) compared to SP. Tumor size did not significantly differ between groups (MD, -0.14 cm; 95% CI, -0.33 to 0.05).ConclusionsECD demonstrates superior perioperative efficiency compared to SP.RelevanceThese findings support the use of ECD as a more efficient surgical option for benign parotid tumors in appropriately selected patients.