Parotid gland pleomorphic adenoma re-operations with regard to patient and surgeon satisfaction: what can be improved?
Surgery, the treatment of choice for parotid pleomorphic adenoma (PA), is associated with facial nerve palsy and decreased quality of life. Re-operation for PA recurrence (rPA) significantly increases these risks and constitutes a dilemma for both patient and surgeon. Factors influencing the success...
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| Veröffentlicht in: | Annals of medicine (Helsinki) 2023-12, Vol.55 (1), p.881-888 |
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| creator | Bartkowiak, Ewelina Piwowarczyk, Krzysztof Chou, Jadzia Tin-Tsen Klimza, Hanna Wierzbicka, Małgorzata |
| description | Surgery, the treatment of choice for parotid pleomorphic adenoma (PA), is associated with facial nerve palsy and decreased quality of life. Re-operation for PA recurrence (rPA) significantly increases these risks and constitutes a dilemma for both patient and surgeon. Factors influencing the success of re-operation, as well as the self-reported satisfaction of both sides, have yet to be addressed in the literature. This study aims to improve upon the decision-making schedule in PA re-operations, based on patient expectations, imaging, and concordance with the first operative report (FOpR).
Seventy-two rPAs treated in a single tertiary center were collected and analyzed. The FOpRs and pre-operative imaging were divided according to defined criteria into accurate and non-accurate categories. The re-operative field and course were categorized as anticipated or unanticipated. The re-operation was categorized as satisfactory or unsatisfactory for both the patient and the surgeon.
The accuracy of FOpRs and pre-operative imaging was 36.1% and 69.4%, respectively. Re-operative courses were: 36.1% anticipated and 63.9% unanticipated. The most frequently omitted data were: presence of satellite tumors (9.7%), and amount of removed parenchyma (9.7%). Variables that most commonly affected FOpR non-accuracy were: tumor size (Chi2(1)=59.92; p |
| doi_str_mv | 10.1080/07853890.2023.2171106 |
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Seventy-two rPAs treated in a single tertiary center were collected and analyzed. The FOpRs and pre-operative imaging were divided according to defined criteria into accurate and non-accurate categories. The re-operative field and course were categorized as anticipated or unanticipated. The re-operation was categorized as satisfactory or unsatisfactory for both the patient and the surgeon.
The accuracy of FOpRs and pre-operative imaging was 36.1% and 69.4%, respectively. Re-operative courses were: 36.1% anticipated and 63.9% unanticipated. The most frequently omitted data were: presence of satellite tumors (9.7%), and amount of removed parenchyma (9.7%). Variables that most commonly affected FOpR non-accuracy were: tumor size (Chi2(1)=59.92; p < 0.001) and capsule condition (Chi2(1)=29.11; p < 0.001). There was no significant relationship between FOpR accuracy and re-operative course (Chi2(1)=1.14; p = 0.286), patient satisfaction (Chi2(1)=1.94; p = 0.164) or surgeon satisfaction (Chi2(1)=0.04; p = 0.837). Pre-operative imaging (Chi2(1)=36.73; p < 0.001) had the greatest impact on surgeon satisfaction.
Accurate pre-operative imaging impacted surgeon satisfaction. The impact of the FOpR on re-operation technicalities and patient satisfaction was minor. Imaging precision should be improved to streamline the decision-making process of PA re-operation. This article proposes suggestions for a future decision-making algorithm as a starting point for a prospective study.
Key messages
Accurate pre-operative imaging impacts both surgeon and patient satisfaction.
There is no significant relationship between the accuracy of the first operative report and surgeon and patient satisfaction.
There is a statistically significant relationship between patient and surgeon satisfaction.</description><identifier>ISSN: 0785-3890</identifier><identifier>EISSN: 1365-2060</identifier><identifier>DOI: 10.1080/07853890.2023.2171106</identifier><identifier>PMID: 36880798</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adenoma, Pleomorphic - surgery ; contrast-enhanced MR images ; facial nerve ; Humans ; operative report ; Oral oncology ; Parotid Gland - surgery ; pleomorphic adenoma ; Prospective Studies ; Quality of Life ; Surgeons ; Surgery</subject><ispartof>Annals of medicine (Helsinki), 2023-12, Vol.55 (1), p.881-888</ispartof><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2023</rights><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2023 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c535t-b12c1e9df3b8409b7dc4dd1af0c79ed6d6c7a34bb0e0a5fa0ccc847a21a7aca73</citedby><cites>FETCH-LOGICAL-c535t-b12c1e9df3b8409b7dc4dd1af0c79ed6d6c7a34bb0e0a5fa0ccc847a21a7aca73</cites><orcidid>0000-0003-3351-0923 ; 0000-0002-2482-8596 ; 0000-0003-4448-8768 ; 0000-0003-4800-8899 ; 0000-0003-0006-6352</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795636/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795636/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27502,27924,27925,53791,53793,59143,59144</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36880798$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bartkowiak, Ewelina</creatorcontrib><creatorcontrib>Piwowarczyk, Krzysztof</creatorcontrib><creatorcontrib>Chou, Jadzia Tin-Tsen</creatorcontrib><creatorcontrib>Klimza, Hanna</creatorcontrib><creatorcontrib>Wierzbicka, Małgorzata</creatorcontrib><title>Parotid gland pleomorphic adenoma re-operations with regard to patient and surgeon satisfaction: what can be improved?</title><title>Annals of medicine (Helsinki)</title><addtitle>Ann Med</addtitle><description>Surgery, the treatment of choice for parotid pleomorphic adenoma (PA), is associated with facial nerve palsy and decreased quality of life. Re-operation for PA recurrence (rPA) significantly increases these risks and constitutes a dilemma for both patient and surgeon. Factors influencing the success of re-operation, as well as the self-reported satisfaction of both sides, have yet to be addressed in the literature. This study aims to improve upon the decision-making schedule in PA re-operations, based on patient expectations, imaging, and concordance with the first operative report (FOpR).
Seventy-two rPAs treated in a single tertiary center were collected and analyzed. The FOpRs and pre-operative imaging were divided according to defined criteria into accurate and non-accurate categories. The re-operative field and course were categorized as anticipated or unanticipated. The re-operation was categorized as satisfactory or unsatisfactory for both the patient and the surgeon.
The accuracy of FOpRs and pre-operative imaging was 36.1% and 69.4%, respectively. Re-operative courses were: 36.1% anticipated and 63.9% unanticipated. The most frequently omitted data were: presence of satellite tumors (9.7%), and amount of removed parenchyma (9.7%). Variables that most commonly affected FOpR non-accuracy were: tumor size (Chi2(1)=59.92; p < 0.001) and capsule condition (Chi2(1)=29.11; p < 0.001). There was no significant relationship between FOpR accuracy and re-operative course (Chi2(1)=1.14; p = 0.286), patient satisfaction (Chi2(1)=1.94; p = 0.164) or surgeon satisfaction (Chi2(1)=0.04; p = 0.837). Pre-operative imaging (Chi2(1)=36.73; p < 0.001) had the greatest impact on surgeon satisfaction.
Accurate pre-operative imaging impacted surgeon satisfaction. The impact of the FOpR on re-operation technicalities and patient satisfaction was minor. Imaging precision should be improved to streamline the decision-making process of PA re-operation. This article proposes suggestions for a future decision-making algorithm as a starting point for a prospective study.
Key messages
Accurate pre-operative imaging impacts both surgeon and patient satisfaction.
There is no significant relationship between the accuracy of the first operative report and surgeon and patient satisfaction.
There is a statistically significant relationship between patient and surgeon satisfaction.</description><subject>Adenoma, Pleomorphic - surgery</subject><subject>contrast-enhanced MR images</subject><subject>facial nerve</subject><subject>Humans</subject><subject>operative report</subject><subject>Oral oncology</subject><subject>Parotid Gland - surgery</subject><subject>pleomorphic adenoma</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surgeons</subject><subject>Surgery</subject><issn>0785-3890</issn><issn>1365-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNp9kkFv1DAUhCMEokvhJ4B85JLlOXZsh0upKgqVKsEBztaL7ey6SuJgZ3fVf4_T3Vb0wsnSeOaz_TxF8Z7CmoKCTyBVzVQD6woqtq6opBTEi2JFmajLCgS8LFaLp1xMZ8WblO4AoJIUXhdnTCgFslGrYv8TY5i9JZseR0um3oUhxGnrDUHrxjAgia4Mk4s4-zAmcvDzNksbjJbMgUxZduNMlnDaxY0LI0lZSx2aJfCZHLY4E4MjaR3xwxTD3tmLt8WrDvvk3p3W8-L39ddfV9_L2x_fbq4ub0tTs3ouW1oZ6hrbsVZxaFppDbeWYgdGNs4KK4xExtsWHGDdIRhjFJdYUZRoULLz4ubItQHv9BT9gPFeB_T6QQhxozHO3vROM2qhQmGlkzVvGDSONtxUos1ozq3KrIsja9q1g7MmPzti_wz6fGf0W70Je03zqGvBRCZ8PBFi-LNzadaDT8b1efQu7JKupOJMcSogW-uj1cSQUnTd0zkU9FIA_VgAvRRAnwqQcx_-veRT6vHHs-HL0eDHLsQBDyH2Vs9434fYRRyNT3kU_z3jL3jEw0w</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Bartkowiak, Ewelina</creator><creator>Piwowarczyk, Krzysztof</creator><creator>Chou, Jadzia Tin-Tsen</creator><creator>Klimza, Hanna</creator><creator>Wierzbicka, Małgorzata</creator><general>Taylor & Francis</general><general>Taylor & Francis Group</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3351-0923</orcidid><orcidid>https://orcid.org/0000-0002-2482-8596</orcidid><orcidid>https://orcid.org/0000-0003-4448-8768</orcidid><orcidid>https://orcid.org/0000-0003-4800-8899</orcidid><orcidid>https://orcid.org/0000-0003-0006-6352</orcidid></search><sort><creationdate>202312</creationdate><title>Parotid gland pleomorphic adenoma re-operations with regard to patient and surgeon satisfaction: what can be improved?</title><author>Bartkowiak, Ewelina ; Piwowarczyk, Krzysztof ; Chou, Jadzia Tin-Tsen ; Klimza, Hanna ; Wierzbicka, Małgorzata</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c535t-b12c1e9df3b8409b7dc4dd1af0c79ed6d6c7a34bb0e0a5fa0ccc847a21a7aca73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenoma, Pleomorphic - surgery</topic><topic>contrast-enhanced MR images</topic><topic>facial nerve</topic><topic>Humans</topic><topic>operative report</topic><topic>Oral oncology</topic><topic>Parotid Gland - surgery</topic><topic>pleomorphic adenoma</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surgeons</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bartkowiak, Ewelina</creatorcontrib><creatorcontrib>Piwowarczyk, Krzysztof</creatorcontrib><creatorcontrib>Chou, Jadzia Tin-Tsen</creatorcontrib><creatorcontrib>Klimza, Hanna</creatorcontrib><creatorcontrib>Wierzbicka, Małgorzata</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Annals of medicine (Helsinki)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bartkowiak, Ewelina</au><au>Piwowarczyk, Krzysztof</au><au>Chou, Jadzia Tin-Tsen</au><au>Klimza, Hanna</au><au>Wierzbicka, Małgorzata</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Parotid gland pleomorphic adenoma re-operations with regard to patient and surgeon satisfaction: what can be improved?</atitle><jtitle>Annals of medicine (Helsinki)</jtitle><addtitle>Ann Med</addtitle><date>2023-12</date><risdate>2023</risdate><volume>55</volume><issue>1</issue><spage>881</spage><epage>888</epage><pages>881-888</pages><issn>0785-3890</issn><eissn>1365-2060</eissn><abstract>Surgery, the treatment of choice for parotid pleomorphic adenoma (PA), is associated with facial nerve palsy and decreased quality of life. Re-operation for PA recurrence (rPA) significantly increases these risks and constitutes a dilemma for both patient and surgeon. Factors influencing the success of re-operation, as well as the self-reported satisfaction of both sides, have yet to be addressed in the literature. This study aims to improve upon the decision-making schedule in PA re-operations, based on patient expectations, imaging, and concordance with the first operative report (FOpR).
Seventy-two rPAs treated in a single tertiary center were collected and analyzed. The FOpRs and pre-operative imaging were divided according to defined criteria into accurate and non-accurate categories. The re-operative field and course were categorized as anticipated or unanticipated. The re-operation was categorized as satisfactory or unsatisfactory for both the patient and the surgeon.
The accuracy of FOpRs and pre-operative imaging was 36.1% and 69.4%, respectively. Re-operative courses were: 36.1% anticipated and 63.9% unanticipated. The most frequently omitted data were: presence of satellite tumors (9.7%), and amount of removed parenchyma (9.7%). Variables that most commonly affected FOpR non-accuracy were: tumor size (Chi2(1)=59.92; p < 0.001) and capsule condition (Chi2(1)=29.11; p < 0.001). There was no significant relationship between FOpR accuracy and re-operative course (Chi2(1)=1.14; p = 0.286), patient satisfaction (Chi2(1)=1.94; p = 0.164) or surgeon satisfaction (Chi2(1)=0.04; p = 0.837). Pre-operative imaging (Chi2(1)=36.73; p < 0.001) had the greatest impact on surgeon satisfaction.
Accurate pre-operative imaging impacted surgeon satisfaction. The impact of the FOpR on re-operation technicalities and patient satisfaction was minor. Imaging precision should be improved to streamline the decision-making process of PA re-operation. This article proposes suggestions for a future decision-making algorithm as a starting point for a prospective study.
Key messages
Accurate pre-operative imaging impacts both surgeon and patient satisfaction.
There is no significant relationship between the accuracy of the first operative report and surgeon and patient satisfaction.
There is a statistically significant relationship between patient and surgeon satisfaction.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>36880798</pmid><doi>10.1080/07853890.2023.2171106</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3351-0923</orcidid><orcidid>https://orcid.org/0000-0002-2482-8596</orcidid><orcidid>https://orcid.org/0000-0003-4448-8768</orcidid><orcidid>https://orcid.org/0000-0003-4800-8899</orcidid><orcidid>https://orcid.org/0000-0003-0006-6352</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Taylor & Francis Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adenoma, Pleomorphic - surgery contrast-enhanced MR images facial nerve Humans operative report Oral oncology Parotid Gland - surgery pleomorphic adenoma Prospective Studies Quality of Life Surgeons Surgery |
| title | Parotid gland pleomorphic adenoma re-operations with regard to patient and surgeon satisfaction: what can be improved? |
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