Postoperative immune response and surgical stress in selective neck dissection: Comparison between endoscopically assisted dissection and open techniques in cT1-2N0 oral squamous cell carcinoma

• Published in: Journal of cranio-maxillo-facial surgery Vol. 45; no. 8; pp. 1112 - 1116
• Main Authors: Fan, Song, MD, Zhong, Jiang-long, MD, Chen, Wei-xiong, MD, Chen, Wei-liang, MD, Li, Qun-xing, MD, Wang, You-yuan, PhD, Lin, Zhao-yu, PhD, Zhang, Han-qing, PhD, Zhang, Da-ming, MD, Yu, Xin, MD, Liang, Fa-ya, MD, Huang, Xiao-ming, PhD, Dias-Ribeiro, Eduardo, DDS, MSc, Liu, Yong, MD, Lin, Xiang-hua, MD, Zhou, Bin, MD, Liang, Qi-xiang, MD, Sonoda, Celso Koogi, DDS, MSc, PhD, Li, Jin-song, MD, PhD
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-08-2017
• Subjects: Adult; Aged; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Dentistry; Endoscopically assisted selective neck dissection; Endoscopy; Female; Humans; Immune response; Male; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neck Dissection - methods; Neoplasm Staging; Oral squamous cell carcinoma; Postoperative Complications - blood; Postoperative Complications - immunology; Prospective Studies; Stress, Physiological - immunology; Surgery; Surgical stress; oral squamous cell carcinoma; endoscopically assisted selective neck dissection; immune response; surgical stress; Surgical stress; Endoscopically assisted selective neck dissection; Immune response; Oral squamous cell carcinoma
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.11.021

Summary Background Endoscopically assisted selective neck dissection (SND) has recently been applied in clinical N0 cases of oral squamous cell carcinoma (OSCC). However, nothing is known of the immune response after surgery. Methods A total of 60 patients with cT1-2N0 OSCC randomly underwent endoscopically assisted SND and open operations. The serum levels of IL-6, IL-8, IL-10, IL-1b, TNF-a, CRP, cortisol, ACTH, and growth hormone were analyzed before the start of the surgery(T0) and at 2(T1), 6(T2), 24(T3), and 72 hours (T4) after surgery. Results A total of 31 patients were randomized for endoscopic SND, whereas 29 underwent open procedures. The release of IL-6, IL-10 and CRP was significantly lower in the endoscopic group than in the open surgery group (p<0.05), and cortisol levels were also lower in the endoscopic group (p<0.05). Conclusions Endoscopic SND could effectively provide lower inflammatory responses and surgical stress, reducing peri-operative trauma and accelerating recovery.