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Swedish National Parotidectomy Study (SNaPs): Drainless Versus Standard Surgery (SNaPs)

2026年6月2日 更新者:Karl Sandström、Uppsala University Hospital

A Prospective, Randomized, Multicenter Non-Inferiority Trial Evaluating the Safety of Parotidectomy Without Active Surgical Drainage (Svenska Nationella Parotisstudien)

The purpose of this study The purpose of this study is to find out if it is safe to perform surgery on the parotid gland (the large salivary gland in front of the ear) without using a wound drain. A wound drain is a small plastic tube used to remove excess fluid from the surgical site after the operation. Currently, using a drain is the standard practice in Sweden, which often means patients must stay in hospital overnight. Researchers want to see if skipping the drain is just as safe and if it could allow more patients to return home on the same day as their surgery.

What happens during the study

Participants in this study will be randomly assigned to one of two groups during their surgery:

Group 1: Will receive the standard treatment with a wound drain.

Group 2: Will have the surgery performed without a wound drain.

Apart from the use of a drain, all participants will receive the same surgical care. After the operation, researchers will monitor the healing process. Participants will be asked to fill out questionnaires about their health and any symptoms at one week and six months after their surgery.

The goal of the study The main goal is to compare the safety of the two methods. Researchers will look at whether there is any difference in the number of complications, such as fluid build-up (seroma), bleeding, or infections, between those who had a drain and those who did not. The study also aims to evaluate if avoiding a drain improves the patient's quality of life and if it is a more cost-effective approach for the healthcare system.

調査の概要

研究の種類

介入

入学 (推定)

600

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

      • Stockholm、スウェーデン
        • 募集
        • Karolinska University Hospital
      • Trollhättan、スウェーデン
        • 募集
        • NÄL
      • Uppsala、スウェーデン
        • 募集
        • Uppsala University Hospital, Department of Otorhinolaryngology
        • コンタクト:

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Patients scheduled to undergo partial or superficial parotidectomy without concurrent soft tissue surgery, in cases where a wound drain is traditionally used (extirpation of single adjacent lymph nodes is acceptable).
  • ASA physical status class 1-3.
  • Aged 18 years or older.
  • The patient understands the participant information and is able to make an informed choice.

Exclusion Criteria:

  • Previous parotid surgery on the same side
  • Tumour with parapharyngeal extension.
  • Ongoing or planned perioperative treatment with tranexamic acid.
  • Ongoing treatment with dual antiplatelet therapy (single agent therapy, such as Aspirin or Clopidogrel, is not an exclusion criterion).
  • Ongoing treatment with anticoagulants (NOAC, Warfarin) at the time of surgery. NOAC must be discontinued at least 24 hours before surgery.
  • Ongoing treatment with low molecular weight heparin in doses higher than: Fragmin 5000 IU/day, Clexane 40 mg/day, or Innohep 4500 IU/day.Ongoing treatment for malignancy.Known coagulation disorder.
  • Platelet count <150 x 10⁹
  • PK-INR >1.2.
  • Hb <120 g/L.
  • APTT >42s.
  • Preoperative impaired facial nerve function on the affected side (Sunnybrook Facial Grading System score <90).
  • Supplementary postoperative treatment such as radiotherapy or extended surgery.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:ヘルスサービス研究
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Drainless Group (Intervention)
Participants in this group will undergo partial or superficial parotidectomy without the placement of a postoperative active wound drain. The surgical site is closed according to the standard technique, but the suction drain is omitted.
The surgical procedure is performed without the insertion of an active suction drain. All other aspects of the surgical care and postoperative monitoring follow standard protocols.
アクティブコンパレータ:Standard Drain Group (Control)
Participants in this group will undergo partial or superficial parotidectomy with the placement of a postoperative active wound drain, according to current standard clinical routine in Sweden.
An active suction drain is placed in the surgical bed before wound closure, which is the current established clinical practice for parotidectomy in Sweden.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Cumulative incidence of early postoperative complications requiring intervention
時間枠:From the day of surgery up to 7 weeks postoperatively.
The primary outcome is the number of participants experiencing at least one early complication, defined as a salivary fistula, haematoma, seroma/sialocele, or surgical site infection that requires invasive or medical treatment (e.g., aspiration, re-operation, or antibiotics).
From the day of surgery up to 7 weeks postoperatively.

二次結果の測定

結果測定
メジャーの説明
時間枠
Requirement for inpatient hospital care after the day of surgery.
時間枠:From the first postoperative day up to 6 months
Evaluation of the number of participants requiring unplanned hospital admission or prolonged stay related to the surgical procedure.
From the first postoperative day up to 6 months
Postoperative facial nerve function.
時間枠:Baseline (preoperative), at discharge, at 7 weeks, and at 6 months
Assessment of facial nerve function using the Sunnybrook Facial Grading System (SFGS). The SFGS is a clinical evaluation scale that ranges from 0 to 100. A score of 0 indicates complete facial paralysis, while a score of 100 represents normal facial function. Higher scores indicate a better outcome (better facial nerve function).
Baseline (preoperative), at discharge, at 7 weeks, and at 6 months
Incidence of Frey's syndrome
時間枠:6 months postoperatively.
Subjective and objective assessment of gustatory sweating (Frey's syndrome).
6 months postoperatively.
Health-related quality of life (EQ-5D-5L)
時間枠:7 weeks, and 6 months postoperatively
Evaluated using the EQ-5D-5L descriptive system, which comprises 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension is scored from 1 (no problems) to 5 (extreme problems). The digits are combined into a 5-digit health state profile, which is then converted into a single index value. Index values range from less than 0 (where 0 is a state equivalent to death and negative values are states worse than death) to 1.0 (perfect health). Higher scores indicate a better quality of life outcome.
7 weeks, and 6 months postoperatively
Postoperative length of stay
時間枠:Through initial hospital discharge, an average of 1.5 days, assessed up to 7 weeks.
Total number of days spent in hospital following the surgical procedure.
Through initial hospital discharge, an average of 1.5 days, assessed up to 7 weeks.
Symptom-specific outcomes (SwPOI-8)
時間枠:7 weeks and 6 months postoperatively
Measured using the Swedish Parotidectomy Outcome Inventory 8 (SwPOI-8), a disease-specific instrument assessing subjective symptoms after parotid surgery (e.g., pain, sensory disturbances, scarring, facial palsy, sweating, dry mouth). Each of the 8 items is scored on a Likert scale from 0 to 3, with a total score ranging from 0 to 24. Higher scores indicate a greater symptom burden and a worse outcome.
7 weeks and 6 months postoperatively

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年5月6日

一次修了 (推定)

2030年12月1日

研究の完了 (推定)

2032年12月1日

試験登録日

最初に提出

2026年5月19日

QC基準を満たした最初の提出物

2026年5月26日

最初の投稿 (実際)

2026年6月2日

学習記録の更新

投稿された最後の更新 (実際)

2026年6月4日

QC基準を満たした最後の更新が送信されました

2026年6月2日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

Individual participant data will not be shared publicly due to current Swedish legislation and the European General Data Protection Regulation (GDPR), which protect the privacy of study participants. Sharing of pseudonymised individual-level data would require specific legal review and institutional agreements to ensure continued data protection

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米国FDA規制医薬品の研究

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米国FDA規制機器製品の研究

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Omission of active wound drainの臨床試験

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