Impact of Hospital Volume on Outcomes Following Head and Neck Cancer Surgery and Flap Reconstruction

2021 ◽  
Author(s):  
Josef Madrigal ◽  
Laith Mukdad ◽  
Albert Y. Han ◽  
Zachary Tran ◽  
Peyman Benharash ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hospital Volume ◽  
Cancer Surgery ◽  
Flap Reconstruction

scholarly journals Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction

2017 ◽  
Vol 143 (3) ◽  
pp. 292 ◽  
Author(s):  
Joseph C. Dort ◽  
D. Gregory Farwell ◽  
Merran Findlay ◽  
Gerhard F. Huber ◽  
Paul Kerr ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Perioperative Care ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

Hospital Volume and Failure to Rescue after Head and Neck Cancer Surgery

2015 ◽  
Vol 152 (5) ◽  
pp. 783-789 ◽  
Author(s):  
Carolyn L. Mulvey ◽  
Peter J. Pronovost ◽  
Christine G. Gourin
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hospital Volume ◽  
Cancer Surgery ◽  
Failure To Rescue

Frailty, hospital volume, and failure to rescue after head and neck cancer surgery

2017 ◽  
Vol 128 (6) ◽  
pp. 1365-1370 ◽  
Author(s):  
Carrie L. Nieman ◽  
C. Matthew Stewart ◽  
David W. Eisele ◽  
Peter J. Pronovost ◽  
Christine G. Gourin
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hospital Volume ◽  
Cancer Surgery ◽  
Failure To Rescue

scholarly journals Reconstruction with free flaps in robotic head-and-neck onco-surgeries

2018 ◽  
Vol 51 (03) ◽  
pp. 283-289 ◽  
Author(s):  
Rajan Arora ◽  
Vinay Kumar Verma ◽  
Kripa Shanker Mishra ◽  
Hemant Bhoye ◽  
Rahul Kapoor
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Free Flap ◽  
Free Flaps ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Good Outcome

ABSTRACT Aims and Objective: The aim of the present article is to highlight how reconstruction with free flaps is different and difficult in cases with robotic head-and-neck cancer surgery. It also highlights the technical guidelines on how to manage the difficulties. Materials and Methods: Eleven patients with oropharyngeal cancer having undergone tumour excision followed by free-flap reconstruction been reviewed here. Nine patients had tumour excision done robotically through intraoral route while neck dissection done with transverse neck crease incision. There is a problem of difficult flap inset in this group of patient. Two patients had intraoral excision of tumour followed by robotic neck dissection via retroauricular incision. With no incision directly on the neck, microvascular anastomosis is challenging in this set of patients. Free flap was used in all the cases to reconstruct the defect. Results: Successful reconstruction with free flap was done in all the cases with good outcome both functionally and aesthetically. Conclusion: Free-flap reconstruction is possible in robotic head-and-neck cancer surgery despite small and difficult access, but it does need practice and some technical modifications for good outcome.

Hospital Volume and Failure to Rescue in Head and Neck Cancer Surgery

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P57-P57
Author(s):  
Carolyn L. Mulvey ◽  
Christine G. Gourin
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hospital Volume ◽  
Cancer Surgery ◽  
Failure To Rescue

Multimodal Analgesia in Head and Neck Free Flap Reconstruction: A Systematic Review

2021 ◽  
pp. 019459982110329
Author(s):  
Beatrice C. Go ◽  
Cammille C. Go ◽  
Kevin Chorath ◽  
Alvaro Moreira ◽  
Karthik Rajasekaran
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Multimodal Analgesia ◽  
Cancer Surgery ◽  
Medical Complications ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Subjective Pain

Objective Postoperative pain after head and neck cancer surgery is commonly treated with opioids, which are associated with considerable side effects. The objective of this study is to analyze the safety and efficacy of using multimodal analgesia (MMA) for patients undergoing head and neck cancer surgery with free flap reconstruction. Data Sources A systematic search was conducted in PubMed, Cochrane, Embase, Scopus, and clinicaltrials.gov. Review Methods All studies comparing patients receiving MMA (gabapentin, corticosteroids, local anesthetic, acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs]) vs patients receiving opioids for head and neck cancer surgery with free flap reconstruction were screened. The primary outcome was postoperative opioid usage. Secondary outcomes included length of stay, subjective pain scores, surgical/medical complications, adverse effects, and 30-day outcomes. Results A total of 10 studies representing 1253 patients (MMA, n = 594; non-MMA, n = 659) met inclusion criteria. Gabapentinoids were the most commonly used intervention (72.9%) followed by NSAIDs (44.6%), acetaminophen (44.3%), corticosteroids (25.1%), ketamine (7.2%), and nerve block (3.4%). Eight studies reported a significant decrease in postoperative opioid usage in the MMA groups. Subjective pain had wider variation, with most studies citing significant pain improvement. There were no differences in surgical outcomes, medical complications, adverse effects, or 30-day mortality and readmission rates. Conclusion With the rise of the opioid epidemic, MMA may play an important role in the treatment of postoperative pain after head and neck cancer surgery. A growing body of literature demonstrates a variety of effective perioperative regimens.

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