Incidence and Factors Associated with Complications in Neck Dissection in Head and Neck Cancer in Sisaket Hospital

Abstract

Background: A neck dissection is a surgical procedure used to treat head and neck cancer that has spread to the neck nodes. Head and neck cancer consists of squamous cell carcinoma of lip nose oral cavity larynx nasopharynx oropharynx hypopharynx and includes all types of thyroid and salivary gland cancer. Due to the small size of the neck anatomy and the vital structure in the neck area, the important factors to be considered before neck dissection are the result of surgery, risks and complications that may arise from the surgery.
Objective: To study the incidence and factors related to complications in neck dissection of head and neck cancer patients and treatment of complications arising from neck dissection.
Methods: Retrospective cohort study, medical records review of head and neck cancer treated with neck dissection in Sisaket Hospital from January 1^st, 2016 to January 1^st, 2021, total of 74 cases. The obtained data were interpreted, and results analyzed using STATA. Statistics, percentage, mean, median, standard deviation, SD), fisher exact test, chi-square and T-test independent were used.
Results: In a study of 74 head and neck cancer patients undergoing neck dissection, the mean operative time was 3.9±1.6 hours (mean ±SD) and the average hospital stay was 10.9±6.2 days (mean ±SD). The rate of complication from neck dissection was 39.2%. The most common complication is chyle leakage 10.8%, spinal accessory nerve injury 6.8%, hematoma/bleeding 4.1%, Marginal mandibular nerve injury) 4.1 %, wound infection/dehiscence 2.7% and pneumonia/aspirated pneumonia 2.7% and risk factor of neck dissection’s complication is sex (p-value =0.04) ,the previous treatment before neck dissection (p-value 0.015) such as chemoradiation, only radiation, previous neck dissection, the long time in operation (p-value <0.001), radical neck dissection(p-value= 0.028 ) and higher Neck staging(N in TNM staging)(p-value =0.016)
Conclusion: The rate of complication from neck dissection was 39.2%. The chyle leakage and internal jugular vein injury were the most common at 10.8%. The factor affecting the complications was sex, the previous treatments before neck dissection, radical neck dissection, higher N staging and prolong operating time.