Cleft Lip Repair Comparison between Inpatient and Outpatient Surgeries: A Multi-surgeon Experience

Introduction:

Great variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. Previous studies have examined the safety of performing CL repair as an outpatient procedure. This study’s aim is to investigate the authors’ institutional experience with CL repair to evaluate if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performing CL repair in an outpatient setting. 

Methods:

This study reviewed patients under one year of age who underwent CL repair between 2012 and 2023 at the authors’ institution. Data collected included patient demographics, perioperative details, ED visits and readmissions within thirty days of surgery, and complications.

 

Results:

145 patients met inclusion criteria. When the surgery was performed as outpatient, there was no significant difference in returning to the ED (p = 0.767) or thirty-day hospital readmission(p = 0.447) compared to those who were performed as an inpatient. Ambulatory patients did not have more postoperative complications (p = 0.698) than inpatients. Bilateral cleft lips were more likely to be performed in the inpatient setting (p = 0.001).Patients selected for inpatient surgery had a significantly lower weight at time of repair (p = 0.033) Patients with a respiratory (p = .006), gastrointestinal (p = 0.004), or hematologic (p = 0.013) comorbidity had a higher readmission rate. Patients were also significantly more likely to be readmitted if they had a younger gestational age at birth (p = 0.005).

 

Conclusion:

There was no increased return to ED or readmission for patients undergoing inpatient versus outpatient cleft lip repair. CL repair can be performed safely in an outpatient setting with careful patient selection.

Purpose:

Expand on safety of ambulatory cleft lip repairs after careful patient selections at a single cleft center.

Key Results:

Contact:

LAURA I GALARZA, MD PGY-4

LGALARZA@UMC.EDU |  601-984-5084