Complications after laryngeal cancer surgery

Postoperative complications of laryngeal cancer? Surgical resection is the main measure to treat laryngeal cancer. Due to the large tumor area, large surgical wound and the patient's own reasons, surgery will cause varying degrees of damage to laryngeal function while treating laryngeal cancer. Observation and care of postoperative complications of laryngeal cancer can reduce and avoid postoperative complications, improve the success rate of surgery and the patient's quality of life.

1. Pharyngeal fistula

Pharyngeal fistula is a common complication after laryngeal cancer surgery. The main causes are: preoperative radiotherapy, difficult healing of surgical wound tissue; old age, poor resistance, wound infection; improper suturing of the laryngeal mucosa during surgery; rupture of the laryngeal mucosa sutures, etc. Pharyngeal fistula usually occurs 8-10 days after surgery. Early postoperative prevention of vomiting, nasogastric feeding, increased nutrition, prevention of wound infection, enhanced oral care, neck pressure bandage, negative pressure drainage, etc. are effective nursing measures to reduce the occurrence of pharyngeal fistula.

2. Lung infection

After tracheotomy, the respiratory tract loses the protective function of the throat, making it easy to get lung infection. If unexplained high fever and cough occur 3-5 days after surgery, consider the possibility of lung infection, and report to the doctor in time for treatment. Nursing measures are: keep the airway moist after tracheotomy to prevent sputum from crusting; strictly follow aseptic operation when suctioning sputum, and suck out respiratory secretions in time; regularly clean and disinfect the inner cannula 4 times a day; nebulize inhalation 3 times a day to dilute sputum; ask the patient to take a deep breath to promote effective sputum discharge, and encourage him to cough up respiratory secretions as much as possible. In addition, early postoperative activities of patients can prevent the occurrence of lung infection.

3. Incision infection

It is mainly caused by the patient's low immune function, wound bleeding, and excessive secretions in the cannula after surgery. Closely observe the bleeding and exudation of the wound after surgery, promptly clear the secretions at the tracheal cannula, keep the dressing at the incision and the surrounding skin dry, and replace the dressing in time when it is contaminated. Generally, the dressing should be replaced each time the inner cannula is cleaned and disinfected. If excessive secretions or infection are found at the incision, sensitive antibiotics should be dripped on the open gauze pad to prevent and treat infection.

4. Subcutaneous emphysema

After tracheotomy, subcutaneous emphysema is easy to occur due to the patient's cough, the large tracheal incision and the relatively small skin incision, and the thin cannula. The scope and degree of subcutaneous emphysema should be closely observed, and treatment should be given according to the cause. For coughing, cough suppressants should be given. Most of it can be absorbed by itself. For severe cases, subcutaneous puncture is performed to exhaust the gas, and adhesive tape or sandbags are used to compress and the changes in the condition are closely observed.

5. Bleeding

It is the most common and most dangerous complication after laryngeal cancer surgery. Primary bleeding after surgery is mostly caused by improper hemostasis during surgery, slippage of the ligature, or damage to the anterior wall of the trachea and blood vessels due to inappropriate cannula. Secondary bleeding is caused by severe coughing that causes bleeding points that have stopped bleeding to bleed again. It is caused by wound infection and vascular wall erosion. If bleeding is not stopped in time during surgery, there is a risk of hemorrhagic shock and death. In order to prevent postoperative bleeding, the body's effective blood volume should be observed, blood pressure and pulse should be measured correctly, the amount and color of negative pressure drainage at the neck wound should be correctly recorded, and the wound should be observed for swelling, congestion and other abnormal conditions. Strict hemostasis during surgery and keeping the cannula in the middle are the key to preventing bleeding. Once bleeding occurs, the doctor should be notified in time to take measures, and sedatives and hemostasis should be given at the same time.