Background: Early postoperative ambulation is well recognized as a potential method for decreasing perioperative complications in general surgery. However, the efficacy of early postoperative ambulation has not been evaluated in head and neck surgery. We conducted a retrospective study to assess the efficacy of ambulation around postoperative day 2 in patients with head and neck cancer who underwent free reconstruction surgery, compared to postoperative day 5 or later.
Methods: Between 2006 and 2009, 37 patients performed ambulation at around postoperative day 2 after free reconstructive surgery. As a control group, 50 patients on postoperative day 5 or later between 2001 and 2005 were selected. The differences between the two groups with respect to incidence of free flap necrosis, delirium, postoperative complications (airway and others), indications of infection and length of hospital stay after surgery were analyzed.
Results: In the early ambulation group, the incidence of free flap necrosis was 5.4%, which was less than that in the control group (10%). Delirium occurred in 5 patients (13.5%) in the early ambulation group, which was less frequent than that in the control group (22.0%). In the early ambulation group, the incidence of postoperative airway complications was less than two-thirds of that in the control group with or without laryngectomy. Other postoperative complications in the early ambulation group were similar in both groups. Duration of antibiotic therapy, duration of fever and length of hospital stay after surgery in the early ambulation group were significantly lower than in the control group.
Conclusion: Early postoperative ambulation in patients with head and neck cancer is efficient and safe in the postoperative period, and may facilitate early hospital discharge.