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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dc.contributor.author Slotman, GJ en_US
dc.contributor.author Matthews, M en_US
dc.contributor.author Fahey, L en_US
dc.contributor.author Thom, S en_US
dc.contributor.author Clark, J en_US
dc.contributor.author Hardy, K en_US
dc.date.accessioned 2014-03-06T05:30:07Z
dc.date.available 2014-03-06T05:30:07Z
dc.date.issued 2011 en_US
dc.identifier.citation Undersea Hyperb Med. 2011 May-Jun;38(3):159-65. en_US
dc.identifier.isbn 1066-2936 en_US
dc.identifier.other 21721349 en_US
dc.identifier.uri http://archive.rubicon-foundation.org/10377
dc.description Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. en_US
dc.description.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. en_US
dc.language.iso en en_US
dc.publisher Undersea and Hyperbaric Medical Society, Inc. en_US
dc.subject wound healing en_US
dc.subject.mesh Adult en_US
dc.subject.mesh Combined Modality Therapy/methods en_US
dc.subject.mesh Female en_US
dc.subject.mesh Head and Neck Neoplasms/mortality/radiotherapy/*surgery en_US
dc.subject.mesh Humans en_US
dc.subject.mesh *Hyperbaric Oxygenation en_US
dc.subject.mesh Lasers, Solid-State/*therapeutic use en_US
dc.subject.mesh Male en_US
dc.subject.mesh Middle Aged en_US
dc.subject.mesh Postoperative Complications/*therapy en_US
dc.subject.mesh Retrospective Studies en_US
dc.title Operative Nd:YAG laser plus postoperative hyperbaric oxygen reduces surgical morbidity after radical head and neck cancer surgery and complex reconstruction. en_US
dc.type Article en_US

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