European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Safety and feasibility of drainless day-case parotidectomy: an 8-year retrospective cohort study from a tertiary centre.
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So Cher Pin, Chan Chelsea, Campbell Amy, Manickavasagam Jaiganesh
Аннотация
PURPOSE: Our retrospective study in 2025 found that the use of haemostatic agents in drainless outpatient parotidectomy (DLOP) is associated with an increased risk of seroma/sialoma formation and possible increase in infection risk. The aim of this study was to compare additional complication rates between DLOP and drained inpatient parotidectomy (DIP) in our centre. The secondary aim was to compare postoperative length of hospital stay between the two groups.
METHODS: A retrospective cohort study was conducted, comparing patients who underwent parotidectomy between 2017 and 2024. Patient, surgical and lesion characteristics were compared between DLOP and DIP. Postoperative complications (facial nerve palsy, post-operative haematoma, Frey's syndrome, ear numbness and flap tip necrosis) and postoperative length of stay of DLOP and DIP were evaluated. Logistic regression analysis was used to determine the factors associated with postoperative complication and failure of same day discharge.
RESULTS: 72.6% (n = 82) and 27.4% (n = 31) of patients underwent DLOP and DIP respectively. Haemostatic agents were used in a significantly higher percentage of patients who underwent DLOP (59.8%) vs. DIP (12.9%) (p < 0.01). In DLOP group, a significantly higher percentage of small lesions (≤ 35 mm) were observed (p = 0.03). Complication rates were not significantly different between both groups. Postoperative haematoma was not observed in either group. Neck dissection (OR 2.02, p = 0.01) and large lesion size (OR 5.42, p = 0.04) were significant factors influencing the risk of facial nerve palsy. 85.37% (n = 70) in the DLOP group were discharged on the same day, compared to 3.23% (n = 1) in DIP group (p < 0.01). The presence of drain was the only significant predictor of failure of same-day discharge (OR 298.20, p < 0.01).
CONCLUSIONS: DLOP, facilitated by the use of haemostatic agents is a feasible approach in carefully selected patients, particularly patients with small lesions. This offers advantages of reduced hospital stay, and resource utilisation. Further large-scale prospective studies are required to strengthen the evidence base and evaluate long-term outcomes, cost-effectiveness, and patient satisfaction.
METHODS: A retrospective cohort study was conducted, comparing patients who underwent parotidectomy between 2017 and 2024. Patient, surgical and lesion characteristics were compared between DLOP and DIP. Postoperative complications (facial nerve palsy, post-operative haematoma, Frey's syndrome, ear numbness and flap tip necrosis) and postoperative length of stay of DLOP and DIP were evaluated. Logistic regression analysis was used to determine the factors associated with postoperative complication and failure of same day discharge.
RESULTS: 72.6% (n = 82) and 27.4% (n = 31) of patients underwent DLOP and DIP respectively. Haemostatic agents were used in a significantly higher percentage of patients who underwent DLOP (59.8%) vs. DIP (12.9%) (p < 0.01). In DLOP group, a significantly higher percentage of small lesions (≤ 35 mm) were observed (p = 0.03). Complication rates were not significantly different between both groups. Postoperative haematoma was not observed in either group. Neck dissection (OR 2.02, p = 0.01) and large lesion size (OR 5.42, p = 0.04) were significant factors influencing the risk of facial nerve palsy. 85.37% (n = 70) in the DLOP group were discharged on the same day, compared to 3.23% (n = 1) in DIP group (p < 0.01). The presence of drain was the only significant predictor of failure of same-day discharge (OR 298.20, p < 0.01).
CONCLUSIONS: DLOP, facilitated by the use of haemostatic agents is a feasible approach in carefully selected patients, particularly patients with small lesions. This offers advantages of reduced hospital stay, and resource utilisation. Further large-scale prospective studies are required to strengthen the evidence base and evaluate long-term outcomes, cost-effectiveness, and patient satisfaction.