Department of Otolaryngology, Head and Neck Surgery, National Cancer Institute Regina Elena, Rome, Italy.
Acta Otorhinolaryngol Ital. 2013 Feb;33(1):16-22.
The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ≤ 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications.
本回顾性研究旨在评估颈清扫术后伤口并发症的危险因素。2006 年至 2009 年期间,罗马国家癌症研究所共对 119 例上呼吸消化道鳞癌患者行颈清扫术。根据不同的变量将术后伤口并发症分为主要或次要并发症,并确定危险因素。20.2%的患者发生术后伤口并发症,不同危险因素的个体患者概率从 2%到 34.1%不等。术前放化疗(CRT)和颈清扫术类型与主要并发症风险增加相关(p≤0.05)。对于接受颈清扫术的头颈部鳞癌患者,既往 CRT 以及根治性颈清扫术/改良根治性颈清扫术是发生主要伤口并发症的危险因素。对于 CRT 后需要行颈清扫术的患者,应告知其手术风险增加,如果肿瘤学上合适,应考虑选择性颈清扫术以降低并发症。