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Head and Neck Surgery

(251) Impact of Prolonged Operative Time on Complications Following Benign Parotidectomy

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • SV

    Sudeepti Vedula, BS

    Medical Student
    Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School
    Piscataway , New Jersey, USA

    • Co-Author(s)

  • DAVID Strum, MD

    Resident Physician
    NYU Grossman School of Medicine Department of Otolaryngology Head and Neck Surgery
    New York, New York, United States

  • AS

    Arman Saeedi, BS, MPH

    Department of Otolaryngology – Head and Neck Surgery, New York University Grossman School of Medicine, USA

  • GM

    Ghayoour Mir, DO

    Assistant Professor
    Rutgers New Jersey Medical School
    Newark, New Jersey, United States

    • Senior Author(s)

  • AJ

    Adam S. Jacobson, MD

    Associate Professor
    NYU Grossman School of Medicine Department of Otolaryngology Head and Neck Surgery
    New York, New York, United States

Disclosure(s):
DAVID Strum, MD: No relevant relationships to disclose.
Ghayoour Mir, DO: No relevant relationships to disclose.


Introduction: Prolonged operative time (POT) is linked with an increased risk of postoperative complications in several specialties. The objective of this study was to identify risk factors for POT in patients undergoing superficial (SP) and total parotidectomy (TP) for benign tumors and to report how POT impacts postoperative outcomes.

Methods: Patients who underwent SP or TP (Current Procedural Terminology codes 42415 and 42420, respectively) were queried via the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) for years 2005 – 2018. Outcomes analyzed include patient demographics, comorbidities, inpatient status, postoperative complications, length of admission, readmissions and reoperation were extracted. Univariate and multivariate analyses were performed to compare post-operative outcomes.

Results: A total of 9341 SP and 703 TP patients were identified. Longer than average operative duration in SP was associated with increased odds of deep skin & soft tissue infection (OR: 4.097, p< 0.001), organ space SSI (OR:3.462, p=0.014), wound disruption (OR:4.184, p=0.003), pneumonia (OR:3.829, p=0.008), cerebrovascular accident (OR:8.588, p=0.007), bleeding requiring transfusion (OR:38.112, p< 0.001), DVT (OR:4.432, p=0.034), sepsis (OR:7.472, p=0.012), readmission (OR:2.024, p< 0.001), unplanned readmission (OR:2.041, p< 0.001), reoperation (OR:1.612, p=0.014), postoperatively. POT in both SP and TP groups were associated with increased length of stay (OR:4.451 & 8.591, p< 0.001, respectively).

Conclusions: POT in parotidectomy for benign parotid tumors is independently associated with increased length of stay. Moreover, POT in SP is associated with several other adverse outcomes such as unplanned readmission, surgical complications, and bleeding requiring transfusion. Understanding the factors that lead to longer operative times can improve postoperative planning, safety, and earlier detection of complications.