SURGICAL ISSUES OF SEGMENTAL MANDIBULAR RESECTION IN THE COMBINATION AND COMPLEX TREATMENT OF LOCALLY ADVANCED AND RECURRENT OROPHARYNGEAL CANCER
https://doi.org/10.17650/2222-1468-2013-0-1-17-21
Abstract
Segmental mandibular resection is frequently a mandatory component of combination surgery in the treatment of locally advanced and recurrent oropharyngeal cancer.
Objective: to detail the specific features of segmental mandibular resection, as applied to combination and complex treatment of locally advanced and recurrent oropharyngeal cancer. This study was based on the clinical observations of 31 patients with locally advanced and recurrent oropharyngeal cancer, who had been operated on in Cancer Surgery Unit One, Nizhny Regional Oncology Dispensary, Branch One (Nizhny Novgorod Oncology Dispensary before 2010), in the period 2005 to 2011.
Results. Postoperative complications developed in 16 (50 %) patients: mild, moderate, and severe complications in 2, 8, and 6 patients, respectively. Thirteen patients were alive more than 2 years after surgery. Among in the deceased (n = 18), the cause of death was primary tumor progression in 10 patients; lung metastases developed in 1 patient; a second primary tumor (central lung cancer) did in 1 case. In the immediate postoperative period, two patients died (from gastric bleedingand pulmonary thromboembolism). In 4 dead patients, the causes of death were unassociated with a tumor process, but were associated with cardiovascular diseases.
Conclusion. Segmental mandibular resection techniques during surgery are responsible for not only the frequency of postoperative complications, but also primarily for the efficiency of performed surgical treatment.
About the Authors
D. V. Sikorsky
Nizhny Novgorod Regional Oncology Dispensary, Branch One
Russian Federation
Cancer Unit One
Russian Federation
Cancer Unit One
S. O. Podvyaznikov
Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow
Russian Federation
Department of Oncology
Russian Federation
Department of Oncology
A. N. Volodin
Nizhny Novgorod Regional Oncology Dispensary, Branch One
Russian Federation
Cancer Unit One
Russian Federation
Cancer Unit One
A. A. Chernyavsky
Nizhny Novgorod State Medical Academy, Ministry of Health of Russia
Russian Federation
Department of Oncology, Radiotherapy, Radiodiagnosis
Russian Federation
Department of Oncology, Radiotherapy, Radiodiagnosis
References
1. Матякин Е.Г., Алиев М.Д., Уваров А.А. и др. Виды резекций нижней челюсти и методы пластики при раке полости рта. Тезисы докладов I Международного симпозиума по пластической и реконструктивной хирургии в онкологии. М., 1997.
2. Удинцов Д.Б. Рак слизистой оболочки щеки: выбор тактики лечения и методов реконструкции. Дис. … канд. мед. наук. М., 2009.
3. Доброхотова В.З. Анализ осложнений реконструктивных операций при злокачественных опухолях полости рта. Дис. … канд. мед. наук. М., 2006.
4. Кропотов М.А. Органосохраняющие и реконструктивные операции на нижней челюсти в комбинированном лечении рака слизистой оболочки полости рта. Дис. … д-ра мед. наук. М., 2003.
5. Maisel R.H., Adams G.L. Osteomiocutaneous reconstruction of the oral cavity. Arch Otolaryngol 1983 Nov;109(11):731–4.
6. Davidson J., Boyd В., Gullane P. et al. A comparison of the results following oromandibular reconstruction using a radial forearm flap with either radial bone or a reconstruction plate. Plast Reconstr Surg 1991 Aug;88(2):201–8.
7. Alonco del Hoyo J., Fernandez Sanroman J., Rubio Bueno P. et al. Primary mandibular reconstruction with bridging plates. J Craniomaxillofac Surg 1994 Feb;22(1):43–8.
8. Guerrissi J.O., Taborda G.A. Immediate mandibular reconstruction use of titanium plate reconstructive system and musculocutaneous pectoralis mayor flap. J Craniomaxillofac Surg 2000;28:284–5.
9. Жарков О.А. Эффективность хирургического лечения больных раком слизистой оболочки полости рта и ротоглотки после радикальной лучевой терапии. Дис. … канд. мед. наук. М., 2007.
10. Алиева С.Б., Романов И.С., Подвязнико в С.О. и др. Эффективность индукционной химиотерапии с использованием доцетаксела, цисплатина и 5-фтор урацила и последующей одновременной химиолучевой терапии в лечении рака глотки и полости рта III–IV стадии. Опухоли головы и шеи 2011;2:14–9.
11. Cmelak A.J., Li S., Goldwasser M.A. et al. Исследование II фазы химиолучевого органосохраняющего лечения резектабельного плоскоклеточного рака гортани или ротоглотки III или IV стадии: результаты исследования Eastern Cooperative Oncology Group Study E2399. J Clin Oncol (русское издание, октябрь – декабрь) 2007;1(4):324–30.
12. Сикорский Д.В., Володин А.Н., Чернявски й А.А., Подвязников С.О. Детализаци я техники срединной мандибулотомии как хирургического доступа в лечении рака задней трети языка. Опухоли головы и шеи 2012;2:79–84.
13. Сикорский Д.В., Володин А.Н., Чернявски й А.А. Укрытие реконструктивной пластины с использованием мышечной части пекторального лоскута при реконструкции нижней челюсти после сегментарной резекции. Опухоли головы и шеи 2012;1:17–22.
Review
For citations:
Sikorsky D.V., Podvyaznikov S.O., Volodin A.N., Chernyavsky A.A. SURGICAL ISSUES OF SEGMENTAL MANDIBULAR RESECTION IN THE COMBINATION AND COMPLEX TREATMENT OF LOCALLY ADVANCED AND RECURRENT OROPHARYNGEAL CANCER. Head and Neck Tumors (HNT). 2013;(1):17-21. https://doi.org/10.17650/2222-1468-2013-0-1-17-21
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