Uvulopalatopharyngoplasty: Does Multilevel Surgery Increase Risk?

作者：Baker Andrew B; Xiao Christopher C; O' Connell Brendan P; Cline Jay M; Gillespie M Boyd

来源：Otolaryngology - Head and Neck Surgery, 2016, 155(6): 1053-1058.

DOI：10.1177/0194599816663180

• UPPP
• sleep surgery
• sleep apnea
• obstructive sleep apnea
• sleep

Objectives. (1) Determine the rate of postoperative complications, reoperation, readmission, and death after uvulopalatopharyngoplasty (UPPP) for sleep apnea through multi-institutional clinical data. (2) Compare outcomes of UPPP between multilevel and single-level procedures for the treatment of sleep apnea.
Study Design. Retrospective database analysis.
Methods. The American College of Surgeons National Surgical Quality Improvement Program-a nationally validated, prospective, multi-institutional database from 2005 to 2013-was analyzed for patients who underwent UPPP, per corresponding Current Procedural Terminology codes. Patients were categorized into 3 groups: UPPP alone, UPPP + nasal cavity (NC), and UPPP + base of tongue (BOT). Perioperative outcome measures of interest include surgical/medical complications, reoperation, readmission, and death. Comparisons were made among surgical groups through univariate cross-sectional analysis.
Results. A total of 1079 patients underwent UPPP; 413 patients had UPPP + NC; and 200 patients had UPPP + BOT procedures. One death was reported for the entire cohort of patients. Among all 3 groups (UPPP, UPPP + NC, and UPPP + BOT), no differences were noted in the rates of medical complications (P =.445), surgical complications (P =.396), reoperation (P =.332), and readmission (P =.447). However, the length of hospital stay in days was greatest for the UPPP + BOT group (UPPP, 0.81 6 0.69; UPPP + NC, 0.87 +/- 0.90; UPPP + BOT, 1.50 +/- 2.70; P<.001).
Conclusion. These national data demonstrate no significant increase in risk when UPPP is performed as a single-or multilevel procedure. When indicated, UPPP with multilevel procedures may be safely performed for treatment of sleep apnea. These data set a benchmark for perioperative risk in UPPP surgery and will prove useful for counseling patients.

• 出版日期2016-12