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Superficial Parotidectomy and Postoperative Drainage

Phillip J. Mofle, MD, Department of General Surgery, Marshfield Clinic Indianhead Center, 1020 Lakeshore Drive, Rice Lake, Wisconsin 54868, USA
Andrew C. Urquhart, MD, Department of Otolaryngology–Head and Neck Surgery, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, Wisconsin 54449, USA

Reprint Requests: Andrew C. Urquhart, MD, Department of Otolaryngology-Head and Neck Surgery, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449; Tel: 715-387-5271; Fax: 715-389-3808; Email: urquhart.andrew{at}marshfieldclinic.org.

Objectives: A shift toward shorter hospitalizations and outpatient procedures has become the standard in perioperative care. Two factors affecting the length of hospitalization following parotidectomy are duration of postoperative drainage and the use of surgical drains. Identifying factors that are predictive of postoperative drainage may allow earlier discharge or selection of patients suitable for outpatient procedures. The aim of this study was to identify any factors that may be predictors of postoperative drainage.

Design: Retrospective review.

Setting: A 500+ bed tertiary care medical center in central Wisconsin.

Participants: Patients who underwent superficial parotidectomies over a 5-year period.

Methods: Clinical charts were retrospectively reviewed. Age, gender, anticoagulation use, history of hypertension, estimated intraoperative blood loss, postoperative complications, total postoperative drainage, length of hospital stay, and final pathology were recorded for each patient. Spearman rank correlation was used to evaluate associations, and the Kruskal-Wallis test was used for subgroup comparisons.

Results: Ninety-six superficial parotidectomies were performed during the 5-year time period and 69 met our criteria for inclusion in the study. Final pathology was directly associated with postoperative drainage with benign tumors having significantly less drainage than malignant tumors (P=0.011). Length of hospital stay was also significantly associated with postoperative drainage (r=0.36, P=0.002). No significant associations with age (P=0.209), gender (P=0.904), history of hypertension (P=0.780), or estimated intraoperative blood loss (P=0.109) were noted.

Conclusions: Malignant pathology is associated with increased postoperative drainage and increased length of hospitalization. Accurately predicting malignancies preoperatively may expedite and facilitate postoperative planning and offer insight into the expected duration of postoperative drainage.

Key Words: Drainage • Health care costs • Length of stay • Parotid gland • Surgery