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Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 1/2019

01-10-2019 | Original Article

Factors Affecting Postoperative Complications After Reconstructive Surgery in Oral Carcinoma Patients: A Prospective Study of 100 Patients

Authors: Prateek Vijay Jain, Bhavesh Bang, Kapila Manikantan, Tiash Sinha, Gautam Biswas, Pattatheyil Arun

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 1/2019

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Abstract

Postoperative complications may result in significant functional morbidity, poor cosmetic results, prolonged hospitalization, preclusion of optimal treatment for the cancer, or even be pose threat to life. We prospectively assessed postoperative complications in 100 patients who underwent surgical resection with free or pedicled flap reconstruction as a primary modality of treatment in patients with carcinoma of the oral cavity. One hundred consecutive patients who underwent reconstructive surgery for oral cancer were prospectively analyzed for age, gender, comorbidities, tumor stage, nodal stage, primary sub-site of tumour, reconstructive procedure (free or pedicled), duration of surgery, blood transfusions during surgery, preoperative weight and body mass index, patient generated subjective global assessment status and tracheostomy to determine their effect on postoperative complications as determined on the CD scale. The sample comprised 100 patients with a mean age of 52.12 years (range 24–80 years) and 74% men (M:F ratio 3:1). A total of 40 patients developed surgical complications (including two deaths) while medical complications were seen in 10 patients (including one death). Tracheostomy (52 vs. 7%, p = 0.002) and age (54 vs. 49 years, p = 0.031) were associated with higher complication rate. Higher age and tracheostomy is associated with higher complications in postoperative period.
Literature
2.
go back to reference Nakatsuka T et al (2003) Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection. J Reconstr Microsurg 19(6):363–368 (discussion 369) CrossRef Nakatsuka T et al (2003) Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection. J Reconstr Microsurg 19(6):363–368 (discussion 369) CrossRef
3.
go back to reference Chang CC et al (2013) Perforator flap from proximal lateral leg for head and neck reconstruction. J Reconstr Microsurg 29(4):263–270CrossRef Chang CC et al (2013) Perforator flap from proximal lateral leg for head and neck reconstruction. J Reconstr Microsurg 29(4):263–270CrossRef
4.
go back to reference Robbins KT et al (1990) Risk of wound infection in patients with head and neck cancer. Head Neck 12(2):143–148CrossRef Robbins KT et al (1990) Risk of wound infection in patients with head and neck cancer. Head Neck 12(2):143–148CrossRef
5.
go back to reference Singh B et al (1999) Factors associated with complications in microvascular reconstruction of head and neck defects. Plast Reconstr Surg 103(2):403–411CrossRef Singh B et al (1999) Factors associated with complications in microvascular reconstruction of head and neck defects. Plast Reconstr Surg 103(2):403–411CrossRef
6.
go back to reference Zafereo ME et al (2010) Complications and functional outcomes following complex oropharyngeal reconstruction. Head Neck 32(8):1003–1011CrossRef Zafereo ME et al (2010) Complications and functional outcomes following complex oropharyngeal reconstruction. Head Neck 32(8):1003–1011CrossRef
7.
go back to reference Jones NF et al (2007) Postoperative medical complications—not microsurgical complications—negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer. Plast Reconstr Surg 119(7):2053–2060CrossRef Jones NF et al (2007) Postoperative medical complications—not microsurgical complications—negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer. Plast Reconstr Surg 119(7):2053–2060CrossRef
8.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef
9.
go back to reference Monteiro E et al (1002) Assessment of the Clavien–Dindo classification system for complications in head and neck surgery. Laryngoscope 124(12):2726–2731CrossRef Monteiro E et al (1002) Assessment of the Clavien–Dindo classification system for complications in head and neck surgery. Laryngoscope 124(12):2726–2731CrossRef
10.
go back to reference Peters TT et al (2014) Relation between age, comorbidity, and complications in patients undergoing major surgery for head and neck cancer. Ann Surg Oncol 21(3):963–970CrossRef Peters TT et al (2014) Relation between age, comorbidity, and complications in patients undergoing major surgery for head and neck cancer. Ann Surg Oncol 21(3):963–970CrossRef
11.
go back to reference Adams P et al (2013) Frailty as a predictor of morbidity and mortality in inpatient head and neck surgery. JAMA Otolaryngol Head Neck Surg 139(8):783–789CrossRef Adams P et al (2013) Frailty as a predictor of morbidity and mortality in inpatient head and neck surgery. JAMA Otolaryngol Head Neck Surg 139(8):783–789CrossRef
12.
go back to reference McMahon JD et al (2013) Postoperative complications after major head and neck surgery with free flap repair—prevalence, patterns, and determinants: a prospective cohort study. Br J Oral Maxillofac Surg 51(8):689–695CrossRef McMahon JD et al (2013) Postoperative complications after major head and neck surgery with free flap repair—prevalence, patterns, and determinants: a prospective cohort study. Br J Oral Maxillofac Surg 51(8):689–695CrossRef
13.
go back to reference Ottery FD (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12(1 Suppl):S15–S19CrossRef Ottery FD (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12(1 Suppl):S15–S19CrossRef
14.
go back to reference Detsky AS et al (1987) What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 11(1):8–13CrossRef Detsky AS et al (1987) What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 11(1):8–13CrossRef
15.
go back to reference Ottery F (2000) Patient-generated subjective global assessment. In: Polisena PMC (ed) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 11–23 Ottery F (2000) Patient-generated subjective global assessment. In: Polisena PMC (ed) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 11–23
16.
go back to reference Bauer J, Capra S, Ferguson M (2002) Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785CrossRef Bauer J, Capra S, Ferguson M (2002) Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785CrossRef
17.
go back to reference Becker GD (1986) Identification and management of the patient at high risk for wound infection. Head Neck Surg 8(3):205–210CrossRef Becker GD (1986) Identification and management of the patient at high risk for wound infection. Head Neck Surg 8(3):205–210CrossRef
18.
go back to reference Dor P, Klastersky J (1973) Prophylactic antibiotics in oral, pharyngeal and laryngeal surgery for cancer: (a double-blind study). Laryngoscope 83(12):1992–1998CrossRef Dor P, Klastersky J (1973) Prophylactic antibiotics in oral, pharyngeal and laryngeal surgery for cancer: (a double-blind study). Laryngoscope 83(12):1992–1998CrossRef
19.
go back to reference Cole RR et al (1987) A predictive model for wound sepsis in oncologic surgery of the head and neck. Otolaryngol Head Neck Surg 96(2):165–171CrossRef Cole RR et al (1987) A predictive model for wound sepsis in oncologic surgery of the head and neck. Otolaryngol Head Neck Surg 96(2):165–171CrossRef
20.
go back to reference Perisanidis C et al (1016) Complications after free flap surgery: do we need a standardized classification of surgical complications? Br J Oral Maxillofac Surg 50(2):113–118CrossRef Perisanidis C et al (1016) Complications after free flap surgery: do we need a standardized classification of surgical complications? Br J Oral Maxillofac Surg 50(2):113–118CrossRef
21.
go back to reference Copeland EM III, Daly JM, Dudrick SJ (1979) Nutritional concepts in the treatment of head and neck malignancies. Head Neck Surg 1(4):350–365CrossRef Copeland EM III, Daly JM, Dudrick SJ (1979) Nutritional concepts in the treatment of head and neck malignancies. Head Neck Surg 1(4):350–365CrossRef
22.
go back to reference Brown BM, Johnson JT, Wagner RL (1987) Etiologic factors in head and neck wound infections. Laryngoscope 97(5):587–590CrossRef Brown BM, Johnson JT, Wagner RL (1987) Etiologic factors in head and neck wound infections. Laryngoscope 97(5):587–590CrossRef
23.
go back to reference Girod A et al (1016) Study of the length of hospital stay for free flap reconstruction of oral and pharyngeal cancer in the context of the new French casemix-based funding. Oral Oncol 46(3):190–194CrossRef Girod A et al (1016) Study of the length of hospital stay for free flap reconstruction of oral and pharyngeal cancer in the context of the new French casemix-based funding. Oral Oncol 46(3):190–194CrossRef
24.
go back to reference de Melo GM et al (2001) Risk factors for postoperative complications in oral cancer and their prognostic implications. Arch Otolaryngol Head Neck Surg 127(7):828–833PubMed de Melo GM et al (2001) Risk factors for postoperative complications in oral cancer and their prognostic implications. Arch Otolaryngol Head Neck Surg 127(7):828–833PubMed
25.
go back to reference Ribeiro KDCB, Kowalski LP, de Oliveira MDRD (2003) Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer. Arch Otolaryngol Head Neck Surg 129(2):219–228CrossRef Ribeiro KDCB, Kowalski LP, de Oliveira MDRD (2003) Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer. Arch Otolaryngol Head Neck Surg 129(2):219–228CrossRef
Metadata
Title
Factors Affecting Postoperative Complications After Reconstructive Surgery in Oral Carcinoma Patients: A Prospective Study of 100 Patients
Authors
Prateek Vijay Jain
Bhavesh Bang
Kapila Manikantan
Tiash Sinha
Gautam Biswas
Pattatheyil Arun
Publication date
01-10-2019
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 1/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-018-1304-9

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