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口腔癌患者重建手术后影响术后并发症的因素:一项对100例患者的前瞻性研究。

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

作者信息

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

机构信息

1Department of Head and Neck Surgery, Tata Medical Center, Kolkata, West Bengal 700156 India.

2Department of Clinical Nutrition, Tata Medical Center, Kolkata, West Bengal India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):341-347. doi: 10.1007/s12070-018-1304-9. Epub 2018 Mar 19.

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%,  = 0.002) and age (54 vs. 49 years,  = 0.031) were associated with higher complication rate. Higher age and tracheostomy is associated with higher complications in postoperative period.

摘要

术后并发症可能导致严重的功能障碍、美容效果不佳、住院时间延长、无法进行癌症的最佳治疗,甚至对生命构成威胁。我们前瞻性地评估了100例接受手术切除并采用游离或带蒂皮瓣重建作为口腔癌患者主要治疗方式的患者的术后并发症。对连续100例行口腔癌重建手术的患者进行前瞻性分析,内容包括年龄、性别、合并症、肿瘤分期、淋巴结分期、肿瘤原发亚部位、重建手术方式(游离或带蒂)、手术时长、术中输血情况、术前体重和体重指数、患者主观整体评估状况以及气管切开情况,以确定它们对根据CD量表确定的术后并发症的影响。样本包括100例患者,平均年龄52.12岁(范围24 - 80岁),男性占74%(男:女比例为3: 1)。共有40例患者出现手术并发症(包括2例死亡),10例患者出现医疗并发症(包括1例死亡)。气管切开(52% 对7%,P = 0.002)和年龄(54岁对49岁,P = 0.031)与较高的并发症发生率相关。较高的年龄和气管切开与术后较高的并发症发生率相关。

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