Conservative therapy vs active surgical tactics in the treatment of patients with оrоstomas and pharyngostomas

Abstract

The aim — to develop an integrated therapeutic algorithm and to evaluate its effectiveness for surgical treatment optimizing in patients with оrоstomas and pharyngostomas.Materials and methods. The treatment results of 90 (3 (3.33 %) women and 87 (96.77 %) men, mean age 56.98 ± 0.42 years) with orostomas and pharyngostomas that occurred in the postoperative period of radical treatment for malignant extracranial tumors of the head and neck. The localization of the primary tumor was as follows: 37 (41.11 %) had oral tumors, 29 (32.22 %) — different parts of the pharynx, 24 (26.67 %) had recurrent and residual tumors of the larynx after radical course of radiotherapy. Patients were treated with conservative and surgical methods. The quality of life was assessed using a specialized scale (Performance status scale for head and neck patients).Results and discussions. It is established that the application of the developed algorithm allows to optimize the medical process and statistically significantly improve the quality of life of patients in terms of «habitual diet completeness « and «the possibility of public food intake» in 1.8 and 2.5 times respectively (p < 0.05).Conclusions. The integrated algorithm with application of both conservative and surgical methods, in particular, plastic closure, allows to achieve stable healing of the orostomas and pharyngostomas and to improve the social adaptation of this category of patients.