Laryngopharyngeal surgery option for outpatients

Laryngopharyngeal surgeries that are performed in an ambulatory setting demonstrate low complication and admission rates, suggesting that such procedures can be carried out safely on an outpatient basis, show findings from a US study.

"However, complications such as hemorrhage are not rare, and a small percentage of patients will require hospitalization," say Sunil Verma and Hossein Mahboubi from the University of California in Irvine.

As the field of laryngology has continued to develop and expand, experts have begun to question not only whether the number of laryngopharyngeal surgeries has risen proportionally, but also whether routine laryngopharyngeal surgery can still be considered safe, explain the researchers in Archives of Otolaryngology - Head and Neck Surgery.

Previous reports have challenged the safety of the surgery and have encouraged the admission of patients post-procedure. However, "until now, these risks had not been quantified at a national level," say Verma and Mahboubi.

In the current analysis, patient records from the 1996 and 2006 National Survey of Ambulatory Surgery revealed no significant changes in the number, demographics, and outcomes of patients who underwent laryngopharyngeal surgeries over the 10-year period. The total estimated number of patients who underwent the surgery in 1996 and 2006 were 176,305 and 189,930, respectively.

The disposition status after surgery was routine in 87.6% of cases, while 2.4% were referred to an observation unit, and 3.3% were admitted to hospital. Post-surgery status was not specified for 6.7% of patients.

Perioperative complications were reported in 9.7% of cases and included high blood pressure (1.6%), nausea (1.6%), hemorrhage (1.2%), and vomiting (0.4%). Complications were not specified in 5.0% of patients.

There were no reports of cardiac arrest, arrhythmia, embolism, syncope, blood transfusion, accidental laceration, apnea, airway obstruction, malignant hyperthermia, shock, or hypoxia.

"Evaluation of these data in comparison with the existing literature confirms the notion that, in general, ambulatory laryngopharyngeal surgery is safe," write the authors.

"These results could establish a foundation for future studies on ambulatory laryngopharyngeal surgeries to assess the accompanying risk factors," they conclude.

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