Harréus Ulrich
Department of Otolaryngology/Head and Neck Surgery, University Hospital Munich, Campus Grosshadern, Munich, Germany.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2013 Dec 13;12:Doc04. doi: 10.3205/cto000096.
Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery.
头颈外科手术是头颈癌治疗的基本原则之一。手术失误和不当行为可能对接受治疗的患者产生致命后果。它可能导致功能障碍,并影响未来与疾病相关的生存机会。头颈外科医生面临许多可能导致失误和不当行为的风险。为避免手术失误,对患者进行全面的术前管理是必不可少的。这包括确保可操作性、谨慎评估术前诊断和手术规划。此外,了解头颈的解剖结构、医学研究和数据,具备现代手术技术的资质以及外科医生进行批判性自我评估的能力,是头颈外科医生识别风险和预防失误的基本且重要的先决条件。此外,对头颈癌患者的营养管理、伤口愈合有深入了解,并能够在并发症发生时认识并处理它们,这一点也很重要。尽管采取了所有预防措施和手术护理,失误仍无法总是避免。因此,能够处理失误并为此类事件建立适当且明确的沟通和管理机制非常重要。本文稿对头颈癌手术术前、术中和术后阶段风险和失误的识别与预防进行了评论。