Perioperative management in head and neck cancer surgery

Abstract

Major surgery for the resection of head and neck cancers followed by free tissue transfer reconstruction requires both a long operation time and multiple surgical fields, and is thus relatively invasive for patients. In recent years, the utility of perioperative management by the Enhanced Recovery After Surgery （ERAS） program has been proposed, and it is spreading in various fields of surgery as a sophisticated perioperative management methodology. However, the role of the ERAS program in head and neck surgery remains undeveloped. At our institution, perioperative management of these head and neck surgeries since September 2016 has been conducted according to our own ERAS program including preoperative glucocorticoid administration. Our retrospective study revealed the stability of hemodynamics, less inflammatory response, and maintenance of immune function in the ERAS group, without increasing infections. Thus, our head and neck ERAS program may contribute to the perioperative management of major head and neck surgery with free tissue transfer reconstruction.