Predictive factors for postoperative wound complications after neck dissection

Acta Otorhinolaryngol Ital. 2013 Feb;33(1):16-22.

Abstract

The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ≤ 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications.

L'obiettivo di questo studio retrospettivo è stato quello di valutare i fattori di rischio per le complicanze della ferita chirurgica dopo svuotamento linfonodale del collo. Dal 2006 al 2009, 119 pazienti con carcinoma squamoso delle prime vie aero-digestive sono stati sottoposti a svuotamento del collo presso l'Istituto Nazionale Tumori di Roma. Le complicanze della ferita chirurgica sono state classificate in maggiori e minori al fine di identificare i fattori di rischio delle stesse. Il 20.2% dei pazienti ha presentato complicanze della ferita chirurgica nel postoperatorio con una probabilità individuale che variava dal 2% al 34.1% a seconda dei fattori di rischio. La chemio-radioterapia preoperatoria e il tipo di svuotamento del collo (radicale o radicale modificato) sono associati ad un rischio aumentato (p ≤ 0.05) di complicanze maggiori della ferita chirurgica in pazienti trattati per carcinoma squamoso delle prime vie aero-digestive.

Keywords: Chemoradiation therapy; Complications; Head and neck; Neck Dissection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Head and Neck Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection / adverse effects*
  • Postoperative Complications / epidemiology*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology