Operative Nd:YAG laser plus postoperative hyperbaric oxygen reduces surgical morbidity after radical head and neck cancer surgery and complex reconstruction.

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Operative Nd:YAG laser plus postoperative hyperbaric oxygen reduces surgical morbidity after radical head and neck cancer surgery and complex reconstruction.

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Title: Operative Nd:YAG laser plus postoperative hyperbaric oxygen reduces surgical morbidity after radical head and neck cancer surgery and complex reconstruction.
Author: Slotman, GJ; Matthews, M; Fahey, L; Thom, S; Clark, J; Hardy, K
Abstract: Complications after radical head and neck cancer surgery in irradiated patients are frequent and life-threatening. Hemorrhage, salivary fistulas, wound infections that expose the carotid sheath, among others, make these patients difficult management challenges in the ICU. We studied the effects of Nd:YAG laser surgery plus hyperbaric oxygen (HBO2) therapy on radical head and neck resections and complex reconstruction as a means of reducing postoperative morbidity and mortality. METHODS: 43 head and neck cancer patients were reviewed. Eight (STD) had standard surgery; 35 (YAG:HBO2) had Nd:YAG laser and postoperative HBO2. RESULTS: Age, staging, primary tumor site, sex, reconstruction procedure and transfusion did not differ between STD and YAG/HBO2. All STD and Nd:YAG/HBO2 patients were irradiated, median dosages 5,000 centi-Gray (cGy) and 7,000 cGy, respectively (p = 0.073). Median blood loss was 1,000 ml STD and 700 ml YAG/HBO2 (p = 0.046). There were no postoperative deaths. Major surgical site complications developed in 63 percent of the STD and 17 percent of the YAG/HBO2 patients (p = 0.017). All STD and 62 percent of YAG/HBO2 cancers recurred within 28 months of surgery (p = 0.152). Within the STD and YAG/HBO2 groups, 100 percent and 77 percent of deaths, respectively, were due to cancer. CONCLUSIONS: Combined Nd:YAG laser surgery and HBO2 reduces morbidity in radical head and neck cancer surgery. Recurrent disease and poor cancer survival remain common in this high-risk population.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/10377
Date: 2011

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