■评估手术和术后管理策略,这些策略有助于最大程度地减少晚期口腔癌手术中对预防性气管造口术进行气道管理的需求。
■对接受晚期口腔癌手术的患者进行回顾性回顾,从2015年2月到2024年1月在我们的机构。
■在本评论中,66名患者(男性,n=54;女性,n=12;平均年龄50.3岁),他们在我们机构接受了晚期口腔癌(T3,T4口腔鳞状细胞癌和下颌骨骨肉瘤需要下颌骨切除术)的手术。60例患者(90.9%)在下颌骨节段切除后进行了重建,无需预防性气管造口术。在这些中,18例(27.27%)患者需要下颌骨穿越中线节段切除。6例患者(9.1%)接受了预防性气管造口术,其中2例患者为单侧肿瘤,4例患者为穿过中线的肿瘤。接受预防性气管造口术的患者与未产生平均持续时间13.3天和7.6天的患者之间的住院时间比较,分别。
■除了一部分老年患者,肥胖,笨重的脖子,那些呼吸受损的人,遵循本准则,对于接受晚期口腔癌手术的患者,可以避免预防性气管造口术。
UNASSIGNED: To evaluate the surgical and postoperative management strategies that contribute to minimizing the need for prophylactic tracheostomy for airway management in advanced oral cancer surgery.
UNASSIGNED: A retrospective review of the patients who underwent surgery for advanced oral cancer, in our institution from February 2015 to January 2024.
UNASSIGNED: In the present review, 66 patients (males, n = 54; females, n = 12; mean age 50.3 years) who were operated for advanced oral cancer (T3, T4 oral squamous cell carcinoma and osteosarcoma of the mandible requiring mandibular resection) in our institution were included. 60 patients (90.9%) had reconstruction after segmental resection of the mandible without the need for prophylactic tracheostomy. Out of these, eighteen patients (27.27%) required segmental resection of the mandible crossing midline. Six patients (9.1%) underwent prophylactic tracheostomy, of which two patients had unilateral tumor and four patients had tumor crossing midline. Comparison of hospital stays between patients who underwent prophylactic tracheostomy and those who did not yielded mean durations of 13.3 days and 7.6 days, respectively.
UNASSIGNED: Except a subset of patients with old age, obesity, bulky neck, and those with respiratory compromise, following the present
guidelines, prophylactic tracheostomy can be avoided in patients undergoing surgery for advanced oral cancer.