Respiratory complications in patients undergoing surgery for oral cavity, pharyngeal, and laryngeal cancer in a tertiary hospital.

Abstract

Background and objective: The incidence of head and neck cancer (HNC) is directly related to tobacco and alcohol consumption, which explains why patients with HNC often present comorbidities, with chronic obstructive pulmonary disease (COPD) being an example. This condition is underdiagnosed, and various authors have demonstrated how its presence increases the incidence of respiratory complications in patients undergoing surgery for HNC. We conducted a study aimed at evaluating respiratory complications in patients undergoing surgery for HNC at the San Pedro University Hospital (HUSP).

Materials and methods: A retrospective and descriptive study was conducted, including all adult patients diagnosed with oral cavity, pharyngeal, or laryngeal carcinoma who underwent surgery at the San Pedro University Hospital (HUSP) in Logroño between 2018 and 2021. Sociodemographic variables, medical history, previous pulmonary evaluation, and respiratory complications were recorded. A two-year follow-up was carried out.

Results: A total of 160 patients were included. 74.4% of the patients were men, and the mean age was 72 years. 69.4% had a smoking habit, and 41.2% consumed alcohol. Comorbidities were documented in 82.5% of patients, with hypertension being the most prevalent, while COPD ranked fifth at 8.1%. Prior to surgery, only 16% of patients underwent spirometry, and fewer than 2% were evaluated in the pulmonary clinic. Ten patients (6.25%) developed respiratory complications. Of these, 80% were smokers, and 30% had COPD, yet none had been evaluated in the pulmonary clinic prior to surgery. Diabetes mellitus and non-epidermoid cancer types were significantly associated with complications (p < 0.05).

Conclusions: 6.25% of patients who underwent surgery for HNC experienced respiratory complications. Although this rate is lower than those reported in other studies, it is noteworthy. This is especially relevant considering that, despite 30% of these patients having a prior diagnosis of COPD, none were evaluated before surgery to optimise treatment for this condition. These findings underscore the importance of identifying and managing COPD in patients with HNC and the need for further research in this area.