Postoperative Bleeding After Facial Cleft Repair: A Retrospective Review of TriNetX Database.

Abstract

Introduction: The objective of this article is to assess and describe the incidence of postoperative hemorrhage after cleft palate surgery (palatoplasty), specifically focusing on the need for a return to the operating room for the management of postoperative hemorrhage.

Methods: The TriNetX federated database was used to identify patients with a diagnosis of cleft lip and/or palate undergoing primary cleft palate repair over a 20-year period from 2003 until 2023. Primary endpoints assessed include postoperative hemorrhage resulting in blood transfusion and/or return to the operating room; Kaplan-Meier analysis was used for statistical analysis.

Results: A total of 13,161 patients with cleft lip or palate over the last 20 years underwent operative intervention (palatoplasty). Of those patients, 97 patients were found to have diagnosis of postoperative bleeding. One hundred seventy-five patients experienced postoperative hemorrhage requiring transfusion of blood product. Seventy patients required return to the operating room for postoperative bleeding in the immediate postoperative period.

Conclusions: Historical reporting of postoperative bleeding suggests a moderate rate of postoperative hemorrhage rate after palatoplasty, occasionally necessitating transfusion and return to operating room after index palatoplasty. The authors' retrospective review of a national database demonstrates a lesser incidence of postoperative hemorrhage than previously noted.