55 cases of perioperative mortality in oral maxillofacial head and neck cancer patients: a retrospective analysis
10.12016/j.issn.2096-1456.2020.09.005
- Author:
SUN Zhongyi
1
;
CHEN Yiming
2
,
3
;
WANG Yi
3
,
4
;
JI Tong
2
,
3
Author Information
1. Department of Oral and Maxillofacial Surgery, the Central Hospital of JA MU SI City
2. Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People'
3. s Hospital, College of Stomatology, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology
4. Department of General dentistry, Shanghai Ninth People'
- Publication Type:Journal Article
- Keywords:
oral maxillofacial- head and neck cancer;
perioperative mortality;
rupture of carotid artery;
radiotherapy;
chemotherapy;
pulmonary infection;
ASA grade
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2020;28(9):575-580
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics of perioperative mortality (POM) in oral maxillofacial head and neck cancer patients.
Methods:A retrospective study was adapted for head and neck cancer patients who were treated and had POM in the department of oral maxillofacial & head and neck oncology in Shanghai Ninth People′s Hospital from Jan 1999 to Dec 2019. Demographic information, disease characteristic and clinical records were collected. The factors of POM were classified into surgical complication, medical complication, mixed complication (surgical and medical) and personal complication. SPSS 17.0 software was used to analyze the cause composition for POM under different condition.
Results : 55 patients were included: 39 were male, and 16 were female. A total of 12 patients had a smoking history. Furthermore, 28 patients had general comorbidities. 20 underwent preoperative radiotherapy and 9 received preoperative chemotherapy. Squamous cell carcinoma was the most frequent pathological diagnosis in 37 patients. A total of 9 patients had tumors in the maxilla and skull base. In addtition, 4 patients had POM preoperatively, 1 patient had POM within the operation, and 50 patients had POM postoperatively. The leading causes of death were as follows: rupture of the carotid artery was the most frequent (8), and the surgical complication of pulmonary infection was the main medical complication (6). Pulmonary infection and hemorrhage were regarded as the main mixed complication (4). Two patients had POM due to personal complications. The higher the American Society of Anesthesiologists (ASA) score, the higher the proportion of medical factors in POM (P=0.039).
Conclusion:The composition of POM in oral maxillofacial- head and neck cancer (OMHNC) patients was complicated. Carotid artery rupture was the most common and fatal surgical complication, especially for those who underwent preoperative radiotherapy. Pulmonary infection was the most frequent medical complication, and those who had a higher ASA grade tended to have more complication.
- Full text:55例口腔颌面头颈部恶性肿瘤患者围手术期死亡病例回顾性分析.pdf
