A Proposal for Orocutaneous Fistula Grading Following Oral Cancer Surgery

Shivakumar Thiagarajan1, Nithyanand Chidambaranathan1, B. Gurukeerthi1, Devendra Chaukar2
1Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
2Department of Head and Neck Oncology, Max Nanavati Hospital, Mumbai, India

Tóm tắt

Orocutaneous fistula (OCF) is a common postoperative complication encountered following surgery for oral cancers with multiple implications. There is no grading system available for this complication which has so many implications that would help in its uniform reporting and management. In this study, we have included patients with oral squamous cell carcinoma operated on between January 2021 and December 2021 and tested a proposed three-tier grading system (grades 1–3) for OCF. Out of the 284 patients at risk of OCF, 37 (13%) patients developed OCF in this cohort. Six patients had grade 1 OCF, 20 patients had grade 2 OCF, and 11 patients had grade 3 OCF. Patients with a higher grade of OCF had prolonged hospital stays and required multiple surgical debridements and/or resuturings, and a few needed another flap, which was statistically significant. The proposed grading system for OCF appears to be useful in grading this complication. However, this needs to be validated in a prospective study across multiple centres.

Tài liệu tham khảo

Ferlay J, Colombet M, Soerjomataram I et al (2018) Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 144(8):1941–1953 Markopoulos AK (2012) Current aspects on oral squamous cell carcinoma. Open Dent J 6:126–130 Khoo MJW, Ooi ASH (2021) Management of postreconstructive head and neck salivary fistulae: a review of current practices. J Plast Reconstr Aesthet Surg 74:2120–2132 Al Deek NF, Wei FC, Tsao CK (2016) Fistulae after successful free tissue transfer to head and neck: its prevention and treatment. Clin Plast Surg 43:739–745 Graboyes E, Garrett-Mayer E, Ellis MA et al (2017) Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer. Cancer 123:4841–4850 Rosenthal DI, Liu L, Lee JH et al (2002) Importance of the treatment package time in surgery and postoperative radiation therapy for squamous carcinoma of the head and neck. Head Neck 24:115–126 Khanh NT, Iyer NG (2015) Management of post-operative fistula in head and neck surgery: Sweeping it under the carpet? World J Otorhinolaryngol 5(4):93–104 Chaukar DA, Deshmukh AD, Majeed T, Chaturvedi P, Pai P, D'Cruz AK (2013) Factors affecting wound complications in head and neck surgery: a prospective study. Indian J Med Paediatr Oncol 34:247–251 Girkar F, Thiagarajan S, Malik A, Sawhney S, Deshmukh A, Chaukar D et al (2019) Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: experience from a tertiary cancer center. Head Neck 41:4121–4127 D’Cruz AK, Chaukar DA, Gupta T (2012) Guidelines for head and neckcancers. Tata Memorial Center, Mumbai, India Dawson C, Gadiwalla Y, Martin T, Praveen P, Parmar S (2017) Factors affecting orocutaneous fistula formation following head and neck reconstructive surgery. Br J Oral Maxillofac Surg 55:132–135 Nair D, Singhvi H, Mair M, Qayyumi B, Deshmukh A, Pantvaidya G et al (2017) Outcomes of surgically treated oral cancer patients at a tertiary cancer centre in India. Indian J Cancer 54:616–620 Fang Q, Yuan J, Du W, Dai L, Zhang X, Luo R (2022) Orocutaneous fistula formation in free flap reconstruction for oral squamous cell carcinoma. Front Oncol 12:887118 Published 2022 Apr 26