Operative and Postoperative Management of Patients after Neck Surgery
Journal Title: Otolaryngologia Polska - Year 2012, Vol 66, Issue 3
Abstract
SUMMARY Introduction: Cancer patients after neck surgeries require specific operative and postoperative management, which to some extent determines the finał outcome of the surgery. Such procedures require particular attention due to the respiratory and gastrointestinal tracts as well as the presence of functionally and morphologically important anatomical structures on the neck. The majority of patients qualified for surgery have concomitant medical conditions, which increases the probability of certain operative and postoperative complications. Preparation for the procedure requires close cooperation between the Iaryngologist-head and neck surgeon, general practitioner and anaesthetist. Aim: The purpose of the paper was to analyse the factors that influence the norma) process of healing in the operative and postoperative periods in patients after neck surgery. Material and Methods: The study group consisted of 220 patients who underwent neck surgery in the years 2007-2010. 92.8% of the operations were performed due to a malignant cancer. The following factors were taken into consideration in the evaluation of the healing process: • tracheotomy as a preceding procedure, • patient's stay in the ICU + analgosedation, • first dressing, • role of suction drainage, • patient mobilisation time. Results: On average, following surgery, patients stayed in the ward for: 5-7 days after selective removal of lymph nodes, 5 days after removal of branchial cleft cyst or persistent thyroglossal duct, 14 days after total laryngectomy, and 12 days after reconstructive laryngeal surgery. All patients after oncological surgery of the oral cavity, oropharynx and larynx stayed in the ICU for the first 24 hours and remained under analgosedation. Laryngeal surgery was performed using a separate surgical incision for tracheotomy. In all cases suction drainage was used for 48 hours. After surgery, patients were mobilised during the first 24 hours in the ward. Conclusion: Appropriate operative and postoperative management, following specific standards, increases the safety of the patient. Providing optimal conditions for healing shortens the patient's stay in the ICU, which reduces the cost of hospitalisation and increases the patient's comfort and quality of life.
Authors and Affiliations
Bartosz Szybiak, Wojciech Golusiński
Keywords
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