| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Jain, Umang Somerville, Jessica Saha, Sujata Hackett, Nicholas James Ver Halen, Jon P. Antony, Anuja K. Samant, Sandeep |
| Description |
Country affiliation: United States Author Affiliation: Jain U ( Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.); Somerville J ( Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.); Saha S ( Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.); Hackett NJ ( Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.); Ver Halen JP ( Department of Plastic, Reconstructive, and Hand Surgery, Baptist Cancer Center-Vanderbilt Ingram Cancer Center, Memphis, Tennessee, USA jpverhalen@gmail.com.); Antony AK ( Division of Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.); Samant S ( Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.) |
| Abstract |
OBJECTIVE: While neck dissection is important in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. We sought to compare preoperative variables and outcomes between clean and contaminated neck dissections, using the 2006-2011 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data sets. STUDY DESIGN: Retrospective review of prospectively maintained database. SETTING: Multicenter (university hospitals; tertiary referral centers). SUBJECTS AND METHODS: A retrospective review was performed of the NSQIP database to identify patients undergoing neck dissection in clean vs oropharyngeal contaminated cases. Clinical factors, comorbidities, epidemiologic factors, and procedural characteristics were analyzed to identify factors associated with 30-day postoperative adverse events, including medical and surgical complications, unplanned reoperation, and mortality. Bivariate and multivariable analyses were performed for the outcome of one or more adverse events. RESULTS: In total, 8890 patients had clean neck dissections, while 572 patients had neck wound contamination with oropharyngeal flora. On multivariable regression analysis, oropharyngeal contamination was a significant risk factor for surgical complications (odds ratio [OR], 3.42; 95% confidence interval [CI], 1.96-5.96; P < .001). However, medical complications and mortality were not significantly different between the 2 cohorts. This finding persisted after subgroup analysis, with removal of all thyroidectomy patients from analysis (OR, 2.33; 95% CI, 1.25-4.36; P = .008). CONCLUSION: Using the ACS-NSQIP data set, this study found an increased risk of surgical complications in the setting of contaminated neck dissections. These data should be used for patient risk stratification, informed consent, and to guide further research. |
| File Format |
HTM / HTML |
| ISSN |
01945998 |
| Issue Number |
1 |
| Volume Number |
153 |
| e-ISSN |
10976817 |
| Journal |
Otolaryngology -- Head and Neck Surgery |
| Language |
English |
| Publisher |
SAGE Publications |
| Publisher Date |
2015-07-01 |
| Publisher Place |
Great Britain (UK) |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Adverse Effects Secretion Humans Middle Aged Risk Factors Discipline Otolaryngology Male Head And Neck Neoplasms Oropharynx Surgical Wound Infection Pharynx Epidemiology Journal Article Surgery Mouth Adult Female Multicenter Study Aged Retrospective Studies Neck Dissection |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Otorhinolaryngology Surgery |
