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口腔癌手术后口腔皮肤瘘管分级的建议

A Proposal for Orocutaneous Fistula Grading Following Oral Cancer Surgery.

作者信息

Thiagarajan Shivakumar, Chidambaranathan Nithyanand, Gurukeerthi B, Chaukar Devendra

机构信息

Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India.

Department of Head and Neck Oncology, Max Nanavati Hospital, Mumbai, India.

出版信息

Indian J Surg Oncol. 2025 Apr;16(2):496-501. doi: 10.1007/s13193-023-01786-w. Epub 2023 Jun 20.

Abstract

Orocutaneous fistula (OCF) is a common postoperative complication encountered following surgery for oral cancers with multiple implications. There is no grading system available for this complication which has so many implications that would help in its uniform reporting and management. In this study, we have included patients with oral squamous cell carcinoma operated on between January 2021 and December 2021 and tested a proposed three-tier grading system (grades 1-3) for OCF. Out of the 284 patients at risk of OCF, 37 (13%) patients developed OCF in this cohort. Six patients had grade 1 OCF, 20 patients had grade 2 OCF, and 11 patients had grade 3 OCF. Patients with a higher grade of OCF had prolonged hospital stays and required multiple surgical debridements and/or resuturings, and a few needed another flap, which was statistically significant. The proposed grading system for OCF appears to be useful in grading this complication. However, this needs to be validated in a prospective study across multiple centres.

摘要

口腔皮肤瘘(OCF)是口腔癌手术后常见的术后并发症,有多种影响。对于这种有诸多影响的并发症,目前尚无分级系统,而分级系统有助于对其进行统一报告和管理。在本研究中,我们纳入了2021年1月至2021年12月期间接受手术的口腔鳞状细胞癌患者,并对提议的OCF三级分级系统(1 - 3级)进行了测试。在284例有OCF风险的患者中,该队列中有37例(13%)患者发生了OCF。6例患者为1级OCF,20例患者为2级OCF,11例患者为3级OCF。OCF分级较高的患者住院时间延长,需要多次手术清创和/或再次缝合,少数患者需要另做皮瓣,这在统计学上具有显著意义。提议的OCF分级系统似乎有助于对这种并发症进行分级。然而,这需要在多个中心进行的前瞻性研究中得到验证。

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