Superficial or partial superficial parotidectomy for the treatment of primary benign parotid tumors.

OBJECTIVE: The extent of surgery in benign superficial parotid tumors has no strong evidence-based consensus. Partial superficial parotidectomy (PSP) is a popular choice among surgeons. We retrospectively evaluated the hypothesis that it carries similar efficacy and greater safety than superficial parotidectomy (SP). PATIENTS AND METHODS: Between 2010 and 2016, 84 patients with benign superficial parotid tumors were enrolled in the study. Deep lobe and recurrent tumors were excluded. The patients were treated by SP; (40 patients) or PSP; (44 patients). The operative and postoperative morbidity, tumor recurrence, operative time, and length of hospitalization were analyzed. RESULTS: There was no significant difference regarding patients or tumors in baseline data. PSP showed significantly shorter operative time (P = .022), and hospital stay (P = .001), as well as significantly lower frequencies of postoperative transient facial nerve paralysis and Frey's syndrome, (P = .042 for each). Permanent facial dysfunction was nonsignificantly greater in SP. No tumor recurrence was detected in either group after a median follow-up of 7 years. CONCLUSIONS: PSP is a quicker and less extensive procedure. It was associated with a shorter hospital stay and fewer complications especially transient facial paralysis and Frey's syndrome with a recurrence rate comparable to that of SP.

One-stage lipectomy superficialization of deep cephalic veins in comparison with secondary lipectomy in arteriovenous dialysis fistula.

OBJECTIVE: Lipectomy is an acceptable method of cephalic vein superficialization in hemodialysis arteriovenous fistula. However, limiting it to be a secondary procedure may prolong time between fistula creation and successful cannulation posing more risk of central venous catheter use. AIM: The aim of this study is to evaluate primary surgical lipectomy performed at the time of arteriovenous fistula creation in comparison with secondary lipectomy. PATIENTS AND METHODS: Between June 2015 and January 2017, 59 adult end-stage renal disease patients were allocated non-randomly to group I, 35 patients had arteriovenous fistula with primary lipectomy of forearm or arm deep cephalic veins, and group II, 24 patients who had secondary lipectomy of deep forearm or arm cephalic veins after primary arteriovenous fistula. RESULTS: Mean body mass index was 28.2 ± 3.2 kg/m2 versus 29.4 ± 2.5 kg/m2 in group I versus II, respectively. Mean time from fistula creation to cannulation was 6 ± 0.5 weeks in group I versus 14.5 ± 5.5 weeks in group II (p < 0.0001*). Immediate technical success was achieved in all cases in both groups. Clinical success was 94.29% (33/35) versus 91.67% (22/24) in group I versus II, respectively. Cumulative 1-year primary patency rate was 88% in primary and 86.47% in secondary lipectomy; p = 0.842. CONCLUSION: Lipectomy is a minimally invasive procedure carried out through small incision(s). Primary and secondary lipectomy procedures have few complications, and acceptable technical and clinical success rates. Primary lipectomy has the advantage to hasten fistula use and diminish central venous catheter dependency.