Objective:
To find out determining factors of elective tracheostomy in patients with head and neck cancer receiving free flap reconstruction in Hualien Tzu Chi hospital.
Material and Methods:
Patients with head and neck cancer receiving combined surgery(tumor wide excision and reconstruction) in Hualien Tzu Chi Hospital, Taiwan from January 1st, 2021 to December 31st, 2021 in tracheostomy group (N=42) and non- tracheostomy group (N=36) were
analysed by retrospective cohort study to find the determining factors of consideration in elective tracheostomy.
Results:
Significant difference were noted in tumor location(P=0.001), mandibulectomy type(P=0.016), neck dissection methods(P=0.014), operation time(P=0.033) between tracheostomy and non tracheostomy group. No significant difference was found in tumor stage, flap type, flap size, flap complication, flap outcome, extubation/weaning time, airway complication, mortality, length of ICU stay, length of hospital stay between tracheostomy and non tracheostomy group.
Conclusions:
Determining factors for patients with head and neck cancer in free flap reconstructive surgery receiving tracheostomy need to be assessed for tumor location, mandibulectomy type and neck dissection methods. A personalized approach to postoperative airway management allowed almost half of our cohort to avoid tracheostomy. Hence, appropriately selected patients may be safely managed without routine tracheostomy.