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 . https://doi.org/10.1016/j.oraloncology.2016.12.008
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 |
DOI: | https://doi.org/10.1016/j.oraloncology.2016.12.008 |
Permanenta länken (URI): | http://hdl.handle.net/10138/233302 |
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
Dexamethasone Head and neck cancer Microvascular reconstruction Complications RANDOMIZED-CONTROLLED-TRIALS ORAL-CAVITY ORTHOGNATHIC SURGERY FREE-FLAP PERIOPERATIVE DEXAMETHASONE POSTOPERATIVE INFECTION SURGICAL COMPLICATIONS RETROSPECTIVE ANALYSIS METAANALYSIS REDUCTION 3122 Cancers 3126 Surgery, anesthesiology, intensive care, radiology 313 Dentistry |
Referentgranskad: | Ja |
Användningsbegränsning: | openAccess |
Parallelpublicerad version: | publishedVersion |
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Filer | Storlek | Format | Granska |
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1_s2.0_S1368837516302433_main.pdf | 300.1Kb | Granska/Öppna |