두경부암 수술 후 메트로니다졸 예방적 사용의 임상적 유용성

최인학; 이호영; 김영찬; 정광윤; 백승국

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자료유형: 학술저널

저자정보: 최인학 이호영 김영찬 정광윤 백승국

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제62권 제12호

발행연도: 2019.1

수록면: 720 - 725 (6page)

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Background and Objectives Head and neck cancer surgery has a high risk of infection, becausesurgical fields are exposed to the oral cavity and the pharynx during surgery. The purposeof this study is to evaluate the usefulness of prophylactic metronidazole by identifying factorscontributing to postoperative fistulas in clean-contaminated head and neck cancer surgery. Subjects and Method A total of 234 patients underwent mucosa-opening surgery betweenJanuary 2002 and October 2015. Of those, 167 patients received conventional prophylactic antibioticsand 67 patients received metronidazole in addition to the conventional prophylactic antibiotics. Various clinical factors were evaluated to find association with postoperative fistula. Results The multivariate analysis showed that the tumor site, advanced T stage, and the preoperativetreatment were significantly associated with fistula formation, and the prophylacticuse of metronidazole significantly reduced the number of postoperative fistulas. Conclusion In cases where the incidence of postoperative fistulas are more likely to increase,such as in the advanced T stage, in oral/pharyngeal cancer, and preoperative non-surgical treatment,prophylactic metronidazole may be useful for preventing postoperative fistulas

참고문헌 (30)

참고문헌 신청

Callender DL / 1999 / Antibiotic prophylaxis in head and neck oncologic surgery: The role of gram-negative coverage / Int J Antimicrob Agents 12(Suppl 1):S21~S25

Mandell-Brown M / 1984 / Cost-effectiveness of prophylactic antibiotics in head and neck surgery / Otolaryngol Head Neck Surg 92(5):520~523

Raine CH / 1984 / Chemoprophylaxis in major head and neck surgery / J R Soc Med 77(12):1006~1009

Johnson JT / 1984 / Efficacy of two third-generation cephalosporins in prophylaxis for head and neck surgery / Arch Otolaryngol 110(4):224~227

Weber RS / 1992 / Ampicillin-sulbactam vs clindamycin in head and neck oncologic surgery. The need for gram-negative coverage / Arch Otolaryngol Head Neck Surg 118(11):1159~1163

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