INTRAOPERATIVE BLOOD LOSS IN HEAD AND NECK CANCER OPERATIONS: A RETROSPECTIVE OBSERVATIONAL STUDY IN A TERTIARY CARE SURGICAL ONCOLOGY CENTER IN CENTRAL INDIA

Abstract

Introduction: Head and Neck cancer surgical operations are often associated with major blood loss requiring substitution, usually by homologous blood transfusion. The goal of this study is to retrospectively examine the intraoperative blood loss for the various types of Head and Neck surgical procedures in a tertiary care center in Central India.

Methodology: Head and neck cancer cases were analysed in this retrospective observational study at Department of Surgical oncology at Sri Aurobindo Institute of Medical Science, Indore.100 biopsy proven oral cancer patients who underwent curative surgery were included in the study. Intraoperative blood loss was assessed depending on site of disease, type of procedure and T-stage of disease and its implication on post-operative hospital stay was noted.

Result: A total of 100 oral cancer patients were analysed out of which majority of patients (36) were Ca buccal mucosa (36%). Blood loss intraoperatively was calculated by using visual assessment method. Average Intraoperative Blood loss was more in Ca buccal mucosa cases (536.11 ml). Average blood loss was more in infrastructural maxillectomyand also when superior alveolectomy was combined with hemimandiblectomy or segmental mandibulectomy, also blood loss was more for T4a disease compared to T1-T3. 30 out of 43 patients with blood loss >400mlhad prolonged hospital stay of more than 7 days with an average of 12 days post-operative hospital stay. This difference in hospital stay was statistically significant.

Conclusion: It is of paramount importance to achieve adequate and meticulous intra-operative haemostasis in oral cancer surgeries in order to decrease the post-operative stay of the patient which will also decrease the economical burden of the patient and family.