Complications from planned, posttreatment neck dissections
| Autor: | Roy B. Sessions, K. William Harter, Kenneth Newkirk, Catherine A. Picken, Kevin J. Cullen, Bruce J. Davidson |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Brachytherapy Postoperative Complications Medicine Humans Neoplasm Staging Retrospective Studies business.industry Neck dissection Radiotherapy Dosage General Medicine Perioperative Chemotherapy regimen Combined Modality Therapy Surgery Tongue Neoplasms Radiation therapy Dissection Otorhinolaryngology Epidermoid carcinoma Head and Neck Neoplasms Carcinoma Squamous Cell Lymph Node Excision Complication business Neck |
| Zdroj: | Archives of otolaryngology--headneck surgery. 125(4) |
| ISSN: | 0886-4470 |
| Popis: | Objective To report the complication rate from planned, posttreatment neck dissections in patients who show control of primary squamous cell carcinoma by chemotherapy and radiotherapy or radiotherapy alone. Design Retrospective review of case series. Setting Georgetown University Medical Center, Washington, DC. Patients Thirty-four patients with clinically positive neck disease treated with organ preservation therapy for squamous cell carcinoma of the head and neck. Interventions Planned neck dissection after treatment with chemotherapy and radiotherapy or radiotherapy alone. Main Outcome Measure Perioperative complications. Results Forty-one neck dissections were performed on 34 patients. Complications were seen in 13 (38%) of 34 patients and 15 (37%) of 41 neck dissections. Wound complications occurred in 9 (22%) of 41 dissections. Neck dissection complication rate did not correlate with previous use of chemotherapy or with the use of brachytherapy at the primary site at the time of the neck dissection. Preoperative radiotherapy dose greater than 70 Gy was associated with complications in 58% vs 29% when preoperative dose was less than 70 Gy ( P =.09). This trend was reflected primarily in wound complications (42% vs 14%; P =.10) and reached significance for skin flap necrosis (33% vs 0%; P =.005). Other factors that were associated with increased complications were preoperative albumin level less than 38 g/L and early neck drain removal. Conclusions The complication rate associated with planned posttreatment neck dissection is similar to that previously reported for neck dissection. Wound complications are more common when higher preoperative radiotherapy doses are used. |
| Databáze: | OpenAIRE |
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