RETRACTED: Carotid Body Tumor Resection: Just as Safe without Preoperative Embolization (Retracted Article)

被引:43
作者
Cobb, Adrienne N. [1 ,2 ]
Barkat, Adel [1 ,3 ]
Daungjaiboon, Witawat [2 ,4 ]
Halandras, Pegge [1 ,3 ]
Crisostomo, Paul [1 ,3 ]
Kuo, Paul C. [1 ,2 ]
Aulivola, Bernadette [1 ,3 ]
机构
[1] Loyola Univ, Med Ctr, Dept Surg, Maywood, IL 60153 USA
[2] Loyola Univ, One MAP Sect Surg Analyt, Dept Surg, Chicago, IL 60611 USA
[3] Loyola Univ, Med Ctr, Div Vasc Surg & Endovasc Therapy, 2160 S 1st Ave, Maywood, IL 60153 USA
[4] Depaul Univ, Dept Predict Analyt, Chicago, IL 60604 USA
关键词
MANAGEMENT; OUTCOMES;
D O I
10.1016/j.avsg.2017.06.149
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Carotid body tumors (CBTs) are rare entities for which surgical resection remains the gold standard. Given their hypervascularity, preoperative embolization is often used; however, controversy exists over whether a benefit is associated. Proponents of embolization argue that it minimizes blood loss and complications. Critics argue that cost and stroke outweigh benefits. This study aimed to investigate the impact of embolization on outcomes following CBT resection. Methods: Patients undergoing CBT resection were identified using the Healthcare Cost and Utilization Project State Inpatient Database for 5 states between 2006 and 2013. Patients were divided into 2 groups: carotid body tumor resection alone (CBTR) and carotid body tumor resection with preoperative arterial embolization (CBETR). Descriptive statistics were calculated using arithmetic means with standard deviations for continuous variables and proportions for categorical variables. Patients were propensity score matched on the basis of sex, age, race, insurance, and comorbidity prior to analysis. Risk-adjusted odds of mortality, stroke, nerve injury, blood loss, and length of stay (LOS) were calculated using mixed-effects regression models with fixed effects for age, race, sex, and comorbidities. Results: A total of 547 patients were identified. Of these, 472 patients underwent CBTR and 75 underwent CBETR. Mean age was 54.7 +/- 16 years. Mean number of days between embolization and resection was 0.65 +/- 0.72 days (range 0-3). When compared with CBTR, there were no significant differences in mortality for CBETR (1.35% vs. 0%, P = 0.316), cranial nerve injury (2.7% vs. 0%, P = 0.48), and blood loss (2.7% vs. 6.8%, P = 0.245). Following risk adjustment, CBETR increased the odds of prolonged LOS (odds ratio 5.3, 95% confidence interval 2.1-13.3). Conclusions: CBT resection is a relatively rare procedure. The utility of preoperative tumor embolization has been questioned. This study demonstrates no benefit of preoperative tumor embolization.
引用
收藏
页码:54 / 59
页数:6
相关论文
共 19 条
[1]  
[Anonymous], 2022, Healthcare Cost and Utilization Project
[2]  
[Anonymous], 2013, APPL PREDICTIVE MODE, DOI DOI 10.1007/978-1-4614-6849-3
[3]   The use of the propensity score for estimating treatment effects: administrative versus clinical data [J].
Austin, PC ;
Mamdani, MM ;
Stukel, TA ;
Anderson, GM ;
Tu, JV .
STATISTICS IN MEDICINE, 2005, 24 (10) :1563-1578
[4]  
CHEDID A, 1974, CANCER, V33, P1635, DOI 10.1002/1097-0142(197406)33:6<1635::AID-CNCR2820330625>3.0.CO
[5]  
2-J
[6]  
DENT TL, 1976, SURGERY, V80, P365
[7]   ADAPTING A CLINICAL COMORBIDITY INDEX FOR USE WITH ICD-9-CM ADMINISTRATIVE DATABASES [J].
DEYO, RA ;
CHERKIN, DC ;
CIOL, MA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (06) :613-619
[8]   Carotid body tumors: The role of preoperative embolization [J].
Kafie, FE ;
Freischlag, JA .
ANNALS OF VASCULAR SURGERY, 2001, 15 (02) :237-242
[9]   Current concepts for the surgical management of carotid body tumor [J].
Knight, TT ;
Gonzalez, JA ;
Rary, JM ;
Rush, DS .
AMERICAN JOURNAL OF SURGERY, 2006, 191 (01) :104-110
[10]  
LAHEY FH, 1947, SURG GYNECOL OBSTET, V85, P281