Enhanced recovery after microvascular reconstruction in head and neck cancer – A prospective study
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Enhanced recovery after microvascular reconstruction in head and neck cancer – A prospective study. / Højvig, Jens H.; Charabi, Birgitte W.; Wessel, Irene; Jensen, Lisa T.; Nyberg, Jan; Maymann-Holler, Nana; Kehlet, Henrik; Bonde, Christian T.
In: JPRAS Open, Vol. 34, 2022, p. 103-113.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Enhanced recovery after microvascular reconstruction in head and neck cancer – A prospective study
AU - Højvig, Jens H.
AU - Charabi, Birgitte W.
AU - Wessel, Irene
AU - Jensen, Lisa T.
AU - Nyberg, Jan
AU - Maymann-Holler, Nana
AU - Kehlet, Henrik
AU - Bonde, Christian T.
N1 - Publisher Copyright: © 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - Objectives: Patients undergoing microvascular reconstruction after head and neck cancer typically have several comorbidities, and the procedures are often followed by complications and prolonged hospitalization. Consequently, the application of enhanced recovery after surgery (ERAS) for these patients undergoing microvascular reconstruction has gained attention in recent years. ERAS is a peri- and postoperative care concept that has repeatedly shown beneficial results for a wide variety of surgical procedures, including microvascular reconstruction. This study presents the results after the introduction of our ERAS protocol for head and neck cancer reconstruction. Methods: We prospectively treated 30 consecutive patients according to our ERAS protocol from June 2019 to December 2020 and compared the results of the treated patients with those of patients treated with our traditional recovery after surgery (TRAS) protocol. We are based on our ERAS protocol on the following core elements of recovery: improved patient information, goal-directed fluid therapy, minimally invasive surgery, opioid-sparing multimodal analgesia, early ambulation, and pre-defined functional discharge criteria. Results: The baseline characteristics of the groups were comparable. The ERAS group had a significantly shorter length of stay (13.1 vs. 20.3 days, p < 0.001), significantly shorter time to ambulation (3.0 days vs. 6.4 days, p < 0.001), shorter time to removal of nasogastric tube (13.3 days vs. 22.7 days, p = 0.05), and fewer tracheostomies performed (10% vs. 90%, p < 0.001). There were no differences in complications, flap survival, or 30-day re-admissions between the two groups. Conclusion: The introduction of ERAS in patients with head and neck cancer undergoing microvascular reconstruction seems safe and results in improved recovery. Level of evidence: 3
AB - Objectives: Patients undergoing microvascular reconstruction after head and neck cancer typically have several comorbidities, and the procedures are often followed by complications and prolonged hospitalization. Consequently, the application of enhanced recovery after surgery (ERAS) for these patients undergoing microvascular reconstruction has gained attention in recent years. ERAS is a peri- and postoperative care concept that has repeatedly shown beneficial results for a wide variety of surgical procedures, including microvascular reconstruction. This study presents the results after the introduction of our ERAS protocol for head and neck cancer reconstruction. Methods: We prospectively treated 30 consecutive patients according to our ERAS protocol from June 2019 to December 2020 and compared the results of the treated patients with those of patients treated with our traditional recovery after surgery (TRAS) protocol. We are based on our ERAS protocol on the following core elements of recovery: improved patient information, goal-directed fluid therapy, minimally invasive surgery, opioid-sparing multimodal analgesia, early ambulation, and pre-defined functional discharge criteria. Results: The baseline characteristics of the groups were comparable. The ERAS group had a significantly shorter length of stay (13.1 vs. 20.3 days, p < 0.001), significantly shorter time to ambulation (3.0 days vs. 6.4 days, p < 0.001), shorter time to removal of nasogastric tube (13.3 days vs. 22.7 days, p = 0.05), and fewer tracheostomies performed (10% vs. 90%, p < 0.001). There were no differences in complications, flap survival, or 30-day re-admissions between the two groups. Conclusion: The introduction of ERAS in patients with head and neck cancer undergoing microvascular reconstruction seems safe and results in improved recovery. Level of evidence: 3
KW - Enhanced recovery after surgery
KW - ERAS
KW - Head and neck cancer
KW - Head and neck reconstruction
KW - Head and neck surgery
KW - Microsurgery
KW - Oral cavity cancer
KW - Oral cavity squamous cell carcinoma
KW - Perioperative care
KW - Reconstructive surgery
U2 - 10.1016/j.jpra.2022.08.001
DO - 10.1016/j.jpra.2022.08.001
M3 - Journal article
C2 - 36263192
AN - SCOPUS:85140017958
VL - 34
SP - 103
EP - 113
JO - J P R A S Open
JF - J P R A S Open
SN - 2352-5878
ER -
ID: 323986208