Dexamethasone in head and neck cancer patients with microvascular reconstruction : No benefit, more complications

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Kainulainen , S , Tornwall , J , Koivusalo , A M , Suominen , A L & Lassus , P 2017 , ' Dexamethasone in head and neck cancer patients with microvascular reconstruction : No benefit, more complications ' , Oral Oncology , vol. 65 , pp. 45-50 .

Titel: Dexamethasone in head and neck cancer patients with microvascular reconstruction : No benefit, more complications
Författare: Kainulainen, S.; Tornwall, J.; Koivusalo, A. M.; Suominen, A. L.; Lassus, Patrik
Upphovmannens organisation: Clinicum
Suu- ja leukakirurgian yksikkö
Oral and Maxillofacial Surgery
Department of Oral and Maxillofacial Diseases
Department of Diagnostics and Therapeutics
Anestesiologian yksikkö
Department of Surgery
Plastiikkakirurgian yksikkö
HUS Perioperative, Intensive Care and Pain Medicine
HUS Head and Neck Center
HUS Musculoskeletal and Plastic Surgery
Datum: 2017-02
Språk: eng
Sidantal: 6
Tillhör serie: Oral Oncology
ISSN: 1368-8375
Permanenta länken (URI):
Abstrakt: Objectives: Glucocorticoids are widely used in association with major surgery of the head and neck to improve postoperative rehabilitation, shorten intensive care unit and hospital stay, and reduce neck swelling. This study aimed to clarify whether peri-and postoperative use of dexamethasone in reconstructive head and neck cancer surgery is associated with any advantages or disadvantages. Materials and methods: This prospective double-blind randomized controlled trial comprised 93 patients. A total dose of 60 mg of dexamethasone was administered to 51 patients over three days peri-and post-operatively. The remaining 42 patients served as controls. The main primary outcome variables were neck swelling, length of intensive care unit and hospital stay, duration of intubation or tracheostomy, and delay to start of possible radiotherapy. Complications were also recorded. Results: No statistical differences emerged between the two groups in any of the main primary outcome variables. However, there were more major complications, especially infections, needing secondary surgery within three weeks of the operation in patients receiving dexamethasone than in control patients (27% vs. 7%, p = 0.012). Conclusions: The use of dexamethasone in oral cancer patients with microvascular reconstruction did not provide a benefit. More major complications, especially infections, occurred in patients receiving dexamethasone. Our data thus do not support the use of peri-and postoperative dexamethasone in oropharyngeal cancer patients undergoing microvascular reconstruction. (C) 2016 Elsevier Ltd. All rights reserved.
Subject: Glucocorticoid
Head and neck cancer
Microvascular reconstruction
3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
313 Dentistry
Referentgranskad: Ja
Användningsbegränsning: openAccess
Parallelpublicerad version: publishedVersion

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