Congenital Choanal Atresia Repair: An Analysis of Adverse Perioperative Events. (November 2018)

• Record Type: Journal Article
• Authors: Patel, Vijay A.; Ramadan, Jad; Carr, Michele M.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 159:Number 5(2018)
• Page Start: 920
• Page End: 926
• Publication Date: 2018-11
• Subjects: choanal atresia -- congenital disorder -- NSQIP -- pediatric -- outcomes; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818797282
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: To identify risk factors and determine the perioperative morbidity of infants undergoing congenital choanal atresia (CCA) repair. Study Design: Retrospective analysis of the ACS-NSQIP-P database (American College of Surgeons National Surgical Quality Improvement–Pediatric). Setting: Tertiary medical center. Subjects and Methods: Patients who underwent CCA repair at age ≤365 days at the time of surgery were queried via the ACS-NSQIP-P database (2013-2016) via Current Procedural Terminology code 30540. Analyzed outcomes include age, length of stay, medical comorbidities, operative time, readmission, reoperation, and postoperative complications. Results: A total of 168 patients were identified, 70 of which were within the neonatal period. Preoperatively, gastrointestinal disease ( P < .0001), mechanical ventilation ( P < .0001), and oxygen supplementation ( P = .0040) were significantly greater in frequency among neonates. For all children preoperatively, ASA class ( P < .0001), chronic lung disease ( P = .0019), oxygen supplementation ( P < .0001), and prematurity ( P = .0016) had a significant impact on prolonged length of stay. Neonates had a persistent requirement for postoperative mechanical ventilation ( P < .0001) and a prolonged length of stay ( P < .00001). Conclusion: Neonates undergoing CCA repair are more likely to have a persistent requirement for postoperative mechanical ventilation and a prolonged length of stay. Recognition of key clinical factors may aid in optimizing perioperative risk assessment, patient counseling, and procedural planning.