[Microsurgical reconstruction and full management of patients with head and neck cancer: importance of a quality approach and a patient care team]. / Reconstruction microchirurgicale et prise en charge globale des patients porteurs de cancer ORL: l'importance d'une approche qualité et d'un circuit protocolisé.

ABSTRACT

UNLABELLED MAIN OF STUDY Management and surgical reconstruction of head and neck cancers remain a challenge. From the first consultation to surgery and radiotherapy it is necessary to gain time to ensure optimum treatment and better survival rates. OBJECTIVE: To establish a kind of quality approach to the management of patients with head and neck cancers. 54 patients who received microsurgical reconstruction after head and neck cancer were included in this study between 1997 and 2006. RESULTS: Multiple data were considered body mass index (BMI), ASA stage, age, existence of a pre-or postoperative radiotherapy, the surgeon's experience and the number of drainage veins. The success rate is superior when more than one draining vein is sutured to the flap for patients with a BMI >20. Radiotherapy does not seem to affect the survival of the flap. CONCLUSION: According to current literature, the survival rate of these patients is better when the overall time care is less than 100 days. That period is possible with a perfect organization of the medical and paramedical team. Therefore, we propose to include these patients in a circuit protocolisation care, which saves time, to better inform patients and improve survival rates.