RADICAL SURGERY AFTER INTENSIVE HIGH-ENERGY IRRADIATION
Radiation treatment of cancer usually has been reserved for surgical failures rather than use of radiation initially, and many surgeons attribute any postoperative complication occurring in or near an irradiated area to radiation effects. However, with the newer radiation techniques, the damage to vasculoconnective tissue can be greatly reduced, leading to less delay in wound healing and less postoperative morbidity. Thus, many therapists and a few surgeons now report that the postoperative morbidity after competent irradiation differs little from that of the surgical procedure alone. To determine the risks involved in major surgery following intensive high-energy radiation, 50 patients with head and neck carcinoma treated with Co/sup 60/ gamma radiation, and subsequently undergoing radical surgery in the irradiated area, were studied. All patients received a 5000- to 7000-r tumor dose in 6 to 7 weeks. In all 50 cases, at least the major portion of the operative field was in irradiated tissue, and in approximates half of the cases, the irradiated volume took in the entire operative field (radical neck dissection). Only 5 cases of postoperative sequelae of a severe nature were encountered, and are discussed in detail. While the highest incidence of complications occurred after Y-6 months, it was felt that the sample was too small for a definitive statement concerning the best time for surgery. Difficulties encountered during the surgical procedure itself may be classified into 2 groups: problems of dissection, which occurred in 10 patients (20%), ranging from minimal stickiness of tissues to difficulty in starting a fascial plane; and excessive bleeding or oozing in 4 cases (8%). It is concluded that the complication rate in the group reported here is not significantly higher than that associated with the radical surgical procedures alone. The technical difficulties encountered during surgery were usually minor and did not limit the surgery in any manner. Thus there is little additional risk in performing radical surgical procedures in an area competently irradiated, providing that the radiation dose has been fractionated properly and that high- energy radiations have been utilized. (BBB)
- Research Organization:
- Univ. of Michigan, Ann Arbor
- Sponsoring Organization:
- USDOE
- NSA Number:
- NSA-18-001469
- OSTI ID:
- 4150275
- Journal Information:
- Arch. Surg., Vol. Vol: 86; Other Information: Orig. Receipt Date: 31-DEC-64
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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