Risk factors for late postoperative bleeding after partial glossectomy for tongue cancer

Abstract

Background

Partial glossectomy is the most common procedure for early-stage tongue cancer. Although late postoperative bleeding occasionally occurs, the associated risk factors have not been adequately identified.

Aims/objectives

We aimed to investigate the rate and risk factors for late postoperative bleeding after transoral partial glossectomy with or without neck dissection for tongue cancer at our institution.

Material and methods

We analysed 211 patients who had undergone transoral partial glossectomy between January 2016 and January 2023. The potential risk factors associated with late postoperative bleeding were investigated using univariate and multivariate logistic regression analyses.

Results

Of the 211 patients, 40 (19%) showed late postoperative bleeding, with 19 (9%) classified as grade IIIa (Clavien-Dindo classification). Regarding all grades, late postoperative bleeding was significantly higher in patients aged <70 years and in those with polyglycolic acid (PGA) sheets (p = .046 and .030, respectively). For grade ≥ IIIa, late postoperative bleeding was significantly higher in patients with a history of anticoagulant/platelet administration, a mucosal defect covered with fibrin glue and a PGA sheet (p = .045 and .026, respectively).

Conclusions and significance

The findings of this study suggest that primary closure decreases the frequency of late postoperative bleeding.

Chinese Abstract

部分舌切除术是早期舌癌最常见的手术。尽管术后出血偶尔会发生, 但相关的危险因素尚未得到充分识别。

目的

我们的目的是调查在我院伴或不伴颈清扫术的经口部分舌切除术治疗舌癌的术后晚期出血的发生率和危险因素

材料和方法

我们分析了 211 名在2016年1月至2023年1月期间接受经口部分舌切除术的患者。使用单变量和多变量逻辑回归分析来研究与术后晚期出血相关的潜在危险因素。

结果

在211 例患者中, 40 例(19%)出现术后晚期出血, 其中 19 例(9%)被归为IIIa 级(Clavien-Dindo 分类)。 对于所有级别, 年龄 小于70 岁的患者和带聚乙醇酸 (PGA) 片的患者的术后晚期出血率均较高(分别为p = 0.046 和 p = 0.030)。 对于 IIIa级及以上的患者, 术后晚期出血率在有抗凝剂/血小板给药史、用纤维蛋白胶和 PGA 覆盖的粘膜缺损的患者中明显较高(分别为 p = .045 和 p = .026)。

结论和意义

本研究的结果表明, 直接缝合可降低术后晚期出血的发生率。

Keywords:

• Tongue cancer
• squamous cell carcinoma
• postoperative bleeding
• risk factor

Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Disclosure statement

The authors report there are no competing interests to declare.