[Comprehensive analysis of unplanned reoperations in head and neck neoplasms]

Objective: To investigate the causes and influencing factors of unplanned reoperation in head and neck neoplasms. Methods: A retrospective analysis was conducted on the clinical data of the operation treated patients with head and neck neoplasm in Cancer Hospital Chinese Academy of Medical Sciences from 2016 to 2018. Results: Among 15 113 cases of head and neck neoplasms, 122 cases underwent unplanned reoperation, with an incidence of 0.81%. Unplanned reoperation mainly occurred within 24 hours after operation. The main causes of reoperation were bleeding (65.57%), lymphatic fistula (15.57%) and vascular crisis (9.84%). Sex, surgical site, grade of the first operation, grade of incision and grade of American Society of Anesthesiologists were associated with unplanned reoperations. The first surgical sites with higher probability of unplanned reoperation were tonsils (15.79%), gingiva (8.93%), oropharynx (8.33%), hypopharynx (4.79%) and tongue (3.17%), respectively. Unplanned reoperation resulted in an average expand of 121.66% in hospitalization time and 99.35% in hospitalization expenses. Conclusions: Unplanned reoperation increases hospital operating costs and patients' burden. We should pay close attention to the situation of patients within 24 hours after operation, and focus on preventing bleeding, lymphatic fistula and vascular crisis.We should make adequate preoperative evaluation and preparation for elderly male patients with high surgical grade, surgical incision and ASA grade, especially for the patients whose surgical sites were tonsil, gingiva, oropharynx, hypopharynx and tongue.