Perioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group

the Pediatric Craniofacial Collaborative Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/Aims: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. Methods: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. The extracted patient characteristics and perioperative variables were summarized and compared. Results: The query yielded 72 cases from 11 institutions: 49 children undergoing Le Fort III and 23 undergoing Monobloc procedures. Monobloc patients were younger, weighed less, and more likely to have tracheostomies along with elevated intracranial pressure. Greater transfusion was observed in the Monobloc group for nearly all of the transfusion outcomes evaluated. Median ICU and hospital length of stay were 2 and 3 days longer, respectively, in the Monobloc group. Perioperative complications were not uncommon, occurring in 18% of patients in the Le Fort III group and 30% in the Monobloc group. Conclusion: Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.

Original languageEnglish (US)
Pages (from-to)710-718
Number of pages9
JournalPaediatric Anaesthesia
Volume28
Issue number8
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Observational Studies
Length of Stay
Pediatrics
Registries
Distraction Osteogenesis
Intracranial Hypertension
Tracheostomy
Operative Time
Demography
Equipment and Supplies

Keywords

  • craniofacial abnormalities
  • craniosynostoses
  • Le Fort osteotomy
  • midface hypoplasia
  • outcomes
  • pediatrics
  • registries

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

Cite this

Perioperative outcomes and management in midface advancement surgery : a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group. / the Pediatric Craniofacial Collaborative Group.

In: Paediatric Anaesthesia, Vol. 28, No. 8, 01.08.2018, p. 710-718.

Research output: Contribution to journalArticle

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title = "Perioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group",
abstract = "Background/Aims: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. Methods: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. The extracted patient characteristics and perioperative variables were summarized and compared. Results: The query yielded 72 cases from 11 institutions: 49 children undergoing Le Fort III and 23 undergoing Monobloc procedures. Monobloc patients were younger, weighed less, and more likely to have tracheostomies along with elevated intracranial pressure. Greater transfusion was observed in the Monobloc group for nearly all of the transfusion outcomes evaluated. Median ICU and hospital length of stay were 2 and 3 days longer, respectively, in the Monobloc group. Perioperative complications were not uncommon, occurring in 18{\%} of patients in the Le Fort III group and 30{\%} in the Monobloc group. Conclusion: Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.",
keywords = "craniofacial abnormalities, craniosynostoses, Le Fort osteotomy, midface hypoplasia, outcomes, pediatrics, registries",
author = "{the Pediatric Craniofacial Collaborative Group} and Glover, {Chris D.} and Fernandez, {Allison M.} and Henry Huang and Christopher Derderian and Wendy Binstock and Russell Reid and Dalesio, {Nicholas M.} and John Zhong and Stricker, {Paul A.} and Christopher Abruzzese and Jesus Apuya and Amy Beethe and Hubert Benzon and Alyssa Brzenski and Stefan Budac and Veronica Busso and Franklin Chiao and Franklyn Cladis and Danielle Claypool and Michael Collins and Ricardo Falcon and Patrick Fernandez and John Fiadjoe and Meera Gangadharan and Katherine Gentry and Susan Goobie and Amanda Gosman and Shannon Grap and Heike Gries and Allison Griffin and Charles Haberkern and John Hajduk and Rebecca Hall and Jennifer Hansen and Mali Hetmaniuk and Vincent Hsieh and Pablo Ingelmo and Iskra Ivanova and Ranu Jain and Michelle Kars and Courtney Kowalczyk-Derderian and Jane Kugler and Kristen Labovsky and Indrani Lakheeram and Andrew Lee and Martinez, {Jose Luis} and Brian Masel and Eduardo Medellin and Petra Meier and Levy, {Heather Mitzel}",
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T2 - a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group

AU - the Pediatric Craniofacial Collaborative Group

AU - Glover, Chris D.

AU - Fernandez, Allison M.

AU - Huang, Henry

AU - Derderian, Christopher

AU - Binstock, Wendy

AU - Reid, Russell

AU - Dalesio, Nicholas M.

AU - Zhong, John

AU - Stricker, Paul A.

AU - Abruzzese, Christopher

AU - Apuya, Jesus

AU - Beethe, Amy

AU - Benzon, Hubert

AU - Brzenski, Alyssa

AU - Budac, Stefan

AU - Busso, Veronica

AU - Chiao, Franklin

AU - Cladis, Franklyn

AU - Claypool, Danielle

AU - Collins, Michael

AU - Falcon, Ricardo

AU - Fernandez, Patrick

AU - Fiadjoe, John

AU - Gangadharan, Meera

AU - Gentry, Katherine

AU - Goobie, Susan

AU - Gosman, Amanda

AU - Grap, Shannon

AU - Gries, Heike

AU - Griffin, Allison

AU - Haberkern, Charles

AU - Hajduk, John

AU - Hall, Rebecca

AU - Hansen, Jennifer

AU - Hetmaniuk, Mali

AU - Hsieh, Vincent

AU - Ingelmo, Pablo

AU - Ivanova, Iskra

AU - Jain, Ranu

AU - Kars, Michelle

AU - Kowalczyk-Derderian, Courtney

AU - Kugler, Jane

AU - Labovsky, Kristen

AU - Lakheeram, Indrani

AU - Lee, Andrew

AU - Martinez, Jose Luis

AU - Masel, Brian

AU - Medellin, Eduardo

AU - Meier, Petra

AU - Levy, Heather Mitzel

PY - 2018/8/1

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N2 - Background/Aims: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. Methods: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. The extracted patient characteristics and perioperative variables were summarized and compared. Results: The query yielded 72 cases from 11 institutions: 49 children undergoing Le Fort III and 23 undergoing Monobloc procedures. Monobloc patients were younger, weighed less, and more likely to have tracheostomies along with elevated intracranial pressure. Greater transfusion was observed in the Monobloc group for nearly all of the transfusion outcomes evaluated. Median ICU and hospital length of stay were 2 and 3 days longer, respectively, in the Monobloc group. Perioperative complications were not uncommon, occurring in 18% of patients in the Le Fort III group and 30% in the Monobloc group. Conclusion: Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.

AB - Background/Aims: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. Methods: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. The extracted patient characteristics and perioperative variables were summarized and compared. Results: The query yielded 72 cases from 11 institutions: 49 children undergoing Le Fort III and 23 undergoing Monobloc procedures. Monobloc patients were younger, weighed less, and more likely to have tracheostomies along with elevated intracranial pressure. Greater transfusion was observed in the Monobloc group for nearly all of the transfusion outcomes evaluated. Median ICU and hospital length of stay were 2 and 3 days longer, respectively, in the Monobloc group. Perioperative complications were not uncommon, occurring in 18% of patients in the Le Fort III group and 30% in the Monobloc group. Conclusion: Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.

KW - craniofacial abnormalities

KW - craniosynostoses

KW - Le Fort osteotomy

KW - midface hypoplasia

KW - outcomes

KW - pediatrics

KW - registries

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U2 - 10.1111/pan.13418

DO - 10.1111/pan.13418

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JO - Paediatric Anaesthesia

JF - Paediatric Anaesthesia

SN - 1155-5645

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