Cleft Lip Repair Comparison Between Inpatient and Outpatient Surgeries: A Multi-Surgeon Experience

Cleft Palate Craniofac J. 2024 Aug 28:10556656241278569. doi: 10.1177/10556656241278569. Online ahead of print.

Abstract

Objective: Great variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. This study's aim is to investigate the authors' institutional experience to see if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performed as outpatient.

Design: This study reviewed patients 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: One hundred forty-five patients met inclusion measures. When the surgery was performed as outpatient, there was no significant difference in returning to the ED (p = 0.767) or readmission to the hospital (p = 0.447) within thirty days as compared to inpatient surgeries. Outpatients did not have more postoperative complications (p = 0.698). Bilateral cleft lips were more likely to be performed as inpatient (p = 0.001). Inpatients had a lower weight at time of repair (p = 0.033). Patients with a respiratory (p = .006), gastrointestinal (p = 0.003), or hematologic (p = 0.013) comorbidity had a higher readmission rate. Patients were more likely to be readmitted if they had a younger gestational age (p = 0.005).

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

Keywords: cleft care; cleft lip; craniofacial surgery; inpatient; outpatient.