Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Microvascular reconstruction in head and neck cancer - basis for the development of an enhanced recovery protocol

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Surgical management of the Tessier 7 cleft: A review and presentation of 5 cases

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Nutrition screening and assessment tools for patients with cancer and survivors of cancer: a systematic review protocol

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Preoperative high-dose Steroids in Total Knee and Hip Arthroplasty - Protocols for three randomized controlled trials

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Introduction: Microvascular reconstructions after head and neck cancer are among the most complicated procedures in plastic surgery. Postoperative complications are common, which often leads to prolonged hospital stay. Enhanced recovery after surgery (ERAS) is a peri- and postoperative care concept with the aim of achieving pain- and risk-free surgery. It has been previously established as superior to conventional care for a wide variety of procedures, including microsurgical procedures such as reconstructions of the breast. Several ERAS protocols for microvascular head and neck cancer reconstructions have been proposed, although most of these are based on extrapolated evidence from different surgical specialties. Results from the implementation of ERAS for these procedures are inconsistent.

Methods: The current study investigates our clinical experience of head and neck cancer reconstruction for the period of 2014-2016 with the aim of establishing a list of functional discharge criteria. By combining these with the current published knowledge on the subject, we developed an ERAS protocol.

Results: We performed 89 microvascular procedures in the study period, of which 58 were in the oral cavity/sinuses and 31 were laryngopharyngeal. Most cases were squamous cell carcinoma (89%). The average LOS was 20.3 days in both groups. Postoperative complications included infection (37%), 30-days re-operations (19%), and re-admissions (17%). Furthermore, we identified the following discharge criteria: adequate pain relief, ambulation, sufficient nutritional intake, normal infection-related blood parameter results and absence of fever, bowel function, and closure of tracheostomy.

Conclusion: Based on our retrospective analysis and identified discharge criteria, we present an approach to develop an ERAS protocol for microvascular reconstruction after head and neck cancer.

OriginalsprogEngelsk
TidsskriftJPRAS Open
Vol/bind26
Sider (fra-til)91-100
Antal sider10
ISSN2352-5878
DOI
StatusUdgivet - 2020

Bibliografisk note

© 2020 The Authors.

ID: 61316462