Sistrunk vs modified Sistrunk procedures: Does procedure type matter?

Arda, Mehmet Sürhan; Ortega, Gezzer; Layman, Ilan B.; Khubchandani, Nisha A.; Pichardo, Margaret S.; Petrosyan, Mikael; Preciado, Diego; Qureshi, Faisal

doi:10.1016/j.jpedsurg.2021.03.044

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Our rate of complications is higher than that reported in the systemic review by Gioacchini, but falls within the range of complication rates of 3.03%–39.4% in literature specific to the Sistrunk procedure in pediatric patients. 19 , 20 , 21 , 22 , 23 , 24 , 25 The most common complications were seroma and SSIs, which is consistent with the literature. 16 , 21 , 23 , 26 , 27 , 28 , 29 Most importantly, we found that the history of infection significantly predicted wound complications.…”

Section: Discussionsupporting

confidence: 90%

“…In this study, the overall rate of postoperative wound complications was 25%. Our rate of complications is higher than that reported in the systemic review by Gioacchini, but falls within the range of complication rates of 3.03%–39.4% in literature specific to the Sistrunk procedure in pediatric patients 19–25 . The most common complications were seroma and SSIs, which is consistent with the literature 16,21,23,26–29 .…”

Section: Discussionsupporting

confidence: 88%

“…The overall rate of cyst recurrence was 11% and it falls within the recurrence range of 0% to 16% in literature specific to the Sistrunk procedure in children. 2 , 8 , 12 , 13 , 16 , 19 , 20 , 21 , 24 , 27 , 30 , 31 , 32 Cyst recurrence was higher with a history of cyst infection but did not reach significance. The higher incidence of prior cyst infection may account for the higher rate of wound complications and recurrence seen in this study.…”

Section: Discussionmentioning

confidence: 88%

“…The overall rate of cyst recurrence was 11% and it falls within the recurrence range of 0% to 16% in literature specific to the Sistrunk procedure in children. 2,8,12,13,16,[19][20][21]24,27,[30][31][32] Cyst recurrence was higher with a history of cyst infection but did not reach significance.…”

Section: Postoperative Complicationsmentioning

confidence: 89%

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Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Wynings,

Wang,

Parsa

et al. 2023

Laryngoscope Investig Oto

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ObjectivesThyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence.MethodsThis was a retrospective case series of pediatric patients undergoing the Sistrunk procedure from June 2009 to April 2021.ResultsA total of 273 patients were included. Of these, 139 (53%) patients were male and 181 (66%) were white. The average age at the time of surgery was 7.1 years. The overall cyst recurrence rate was 11%. The most common wound complications were seroma (14%) and surgical site infections (SSIs) (12%). Wound complications were associated with prior history of cyst infection (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.07–3.60, z‐test 2.2, p = .03). Pediatric surgery was associated with fewer wound complications (OR 0.18; 95% CI 0.05–0.6, z‐test −2.78, p = .005). However, pediatric surgery operated on fewer patients with a history of cyst infection (36% vs. 55%, p = .012). Drain placement and postoperative antibiotics did not affect rates of wound complications.ConclusionsPrior cyst infection is associated with increased rates of postoperative wound complications. Postoperative antibiotics and drain placement did not significantly affect complication rates.Level of Evidence4.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 88%

Section: Postoperative Complicationsmentioning

confidence: 89%

See 2 more Smart Citations

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Wynings,

Wang,

Parsa

et al. 2023

Laryngoscope Investig Oto

View full text Add to dashboard Cite

show abstract

“…Sistrunk's operation remains the mainstay of management for TGD cysts because it has been shown to reduce the risk of recurrence down to 3-10% of adult cases, [17][18][19] and to around 20% in children [20]. There is also a non-negligible rate of postoperative complications and, in a recent large pediatric American series, postoperative rates of cervical seroma, local infection, and need for surgical revision were reported to be 9.5%, 7%, and 7.6%, respectively [21]. For other conditions associated with the TGD remnants instead, the evidence regarding the best surgical approach is weaker.…”

Section: Figurementioning

confidence: 99%

Thyroglossal Duct Lipoma: A Case Report and a Systematic Review of the Literature for Its Management

et al. 2023

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Thyroglossal duct (TGD) remnants in the form of cysts or fistulas usually present as midline neck masses and they are removed along with the central body of the hyoid bone (Sistrunk’s procedure). For other pathologies associated with the TGD tract, the latter operation might be not necessary. In the present report, a case of a TGD lipoma is presented and a systematic review of the pertinent literature was performed. We present the case of a 57-year-old woman with a pathologically confirmed TGD lipoma who underwent transcervical excision without resecting the hyoid bone. Recurrence was not observed after six months of follow-up. The literature search revealed only one other case of TGD lipoma and controversies are addressed. TGD lipoma is an exceedingly rare entity whose management might avoid hyoid bone excision.

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Modified Sistrunk Procedure in 391 Pediatric Thyroglossal Duct Cyst Cases: Clinical Analysis of Efficacy and Recurrence Risk

Li,

Zhang,

et al. 2024

Ear Nose Throat J

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Objectives: The study aims to retrospectively summarize the clinical features of pediatric thyroglossal duct cyst (TGDC), investigate the efficacy of the modified Sistrunk (mSis) procedure, and analyze the recurrence risks. Methods: The clinical data of 391 children with TGDC admitted to Beijing Children’s Hospital affiliated Capital Medical University and Baoding Children’s Hospital from March 2012 to December 2021 were retrospectively analyzed. All patients underwent cervical ultrasound for preoperative evaluation. Twenty cases had magnetic resonance imaging and 8 cases had computed tomography for further evaluation. All patients underwent the standard mSis procedure, and clinical manifestations information, surgical information, complications, and prognosis were analyzed. Results: Among the 391 TGDC cases, 118 (30.2%) had a history of recurrent neck infection and 36 (9.2%) had undergone previous neck cyst and fistula resection surgeries, initially diagnosed as neck cyst (22 cases), TGDC (12 cases), or branchial fistula (2 cases), with only 6 cases having undergone partial hyoid bone resection in the previous operation. During the 15 to 156 months of follow-up, 10 children experienced local wound infection, but no other complications were reported. The recurrence rate was 2.30%, and the recurrence time ranged from 0.5 to 34 (average, 7.2) months post surgery. In the Poisson regression model examining factors related to recurrence, the P values of the 3 factors were <.05: clearness of the lesion boundary, surgical history, and maximum diameter and the relative risk (RR) values corresponding to the 3 risk factors, such as Exp (B), were 27.918, 10.054, and 6.606, respectively. Conclusions: The mSis procedure demonstrated safety and efficacy with fewer complications and a low recurrence rate of 2.30% in the study. Furthermore, the indistinct lesion boundary, surgical history, and large lesion diameter (>2 cm) were independent risk factors for recurrence in pediatric TGDC. Level of Evidence: IV

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Sistrunk vs modified Sistrunk procedures: Does procedure type matter?

Cited by 6 publications

References 30 publications

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Thyroglossal Duct Lipoma: A Case Report and a Systematic Review of the Literature for Its Management

Modified Sistrunk Procedure in 391 Pediatric Thyroglossal Duct Cyst Cases: Clinical Analysis of Efficacy and Recurrence Risk

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