Dong Xiaoqi, Cai Zhuoying, Fang Miaomiao, Zhao Wanru, Liu Yanming
Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
Department of Oral & Maxillofacial Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.
J Stomatol Oral Maxillofac Surg. 2025 Mar;126(2):102035. doi: 10.1016/j.jormas.2024.102035. Epub 2024 Sep 11.
Effective management of oral cancer necessitates a multidisciplinary approach, with surgery playing a pivotal role in treatment. However, there are many risk factors during the perioperative period that affect postoperative recovery.
This study aims to identify the risk factors influencing postoperative recovery in patients undergoing oral cancer surgery, thereby optimizing perioperative management.
STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study was carried out in patients who underwent surgery for oral cancer at The Second Affiliated Hospital Of Zhejiang University School Of Medicine from Jan. to Dec. in 2023. Based on the median length of stay (LOS) of 20.42 days, we divided the study population into DL3W and DM3W groups (DL3W/DM3W: Discharged less/>3 weeks).
The Predictor variables included sex, age, BMI, smoke, drink, education, settlement, surgery history, tumor history, intra-operative situation, flap details, pathologic stage, treatment and laboratory examination.
The primary outcome was length of stay (LOS) defined as the days from the start of preoperative preparation to discharge from the hospital.
Descriptive and inferential analyses were performed using the χ2 test, Fisher's exact test and t-test. A P value of 0.05 was deemed as an acceptable statistical significance level.
The sample was composed of 103 subjects with a mean age of 59.45 (14.20) and 71 (68.9 %) were male. The median LOS was 20.42 ((range, 10-69) days. The baseline characteristics between the DL3W and DM3W groups were generally balanced. Factors associated with LOS were BMI (95 %CI 1.01-1.15, P = 0.046), intraoperative blood loss (95 %CI 0.;99-1.00, P = 0.002), flap source (P < 0.001), and postoperative fasting time (95 %CI 0.88-0.95, P < 0.001). In the regression model, more intraoperative blood loss and longer postoperative fasting time were associated with increased. LOS and factors BMI and the use of forearm flap were associated with decreased LOS after adjusting the confounding factors.
In the perioperative period for oral cancer patients, optimizing postoperative recovery may be achieved by carefully managing BMI, intraoperative blood loss, flap source, and postoperative fasting time.
口腔癌的有效管理需要多学科方法，手术在治疗中起着关键作用。然而，围手术期存在许多影响术后恢复的风险因素。
本研究旨在确定影响口腔癌手术患者术后恢复的风险因素，从而优化围手术期管理。
研究设计、设置、样本：对2023年1月至12月在浙江大学医学院附属第二医院接受口腔癌手术的患者进行回顾性队列研究。根据20.42天的中位住院时间，我们将研究人群分为住院时间小于3周组（DL3W）和住院时间大于3周组（DM3W）（DL3W/DM3W：出院时间小于/大于3周）。
预测变量包括性别、年龄、体重指数、吸烟、饮酒、教育程度、居住地、手术史、肿瘤史、术中情况、皮瓣细节、病理分期、治疗及实验室检查。
主要结局为住院时间（LOS），定义为从术前准备开始至出院的天数。
采用χ2检验、Fisher精确检验和t检验进行描述性和推断性分析。P值为0.05被视为可接受的统计学显著性水平。
样本由103名受试者组成，平均年龄为59.45（14.20）岁，71名（68.9%）为男性。中位住院时间为20.42（范围10 - 69）天。DL3W组和DM3W组之间的基线特征总体平衡。与住院时间相关的因素有体重指数（95%CI 1.01 - 1.15，P = 0.046）、术中失血量（95%CI 0.99 - 1.00，P = 0.002）、皮瓣来源（P < 0.001）和术后禁食时间（95%CI 0.88 - 0.95，P < 0.001）。在回归模型中，调整混杂因素后，术中失血量增加和术后禁食时间延长与住院时间增加相关，体重指数和前臂皮瓣的使用与住院时间减少相关。
在口腔癌患者的围手术期，通过精心管理体重指数、术中失血量、皮瓣来源和术后禁食时间，可能实现术后恢复的优化。
