Digital Surgery Group Versus Traditional Experience Group in Head and Neck Reconstruction: A Retrospective Controlled Study to Analyse Clinical Value and Time-Economic-Social Effect

Abstract

Objective: Explore the application value of digital surgical technology in the reconstruction of head and neck defects after tumor resection, and comprehensively evaluate the operation time and cost-effectiveness.Methods: Retrospective analysis of head and neck cancer patients who underwent reconstruction in head and neck surgery of Sichuan cancer hospital from January 2015 to January 2021. According to the inclusion and exclusion criteria, a total of 52 cases were included, including 25 cases in the digital surgery (DS) group and 27 cases in the conventional surgery (CS) group. The clinical pathological characteristics, postoperative complications, functional and aesthetic evaluation indexes and time-cost-satisfaction evaluation indexes of the two groups were compared and statistically analyzed. Typical cases of digital surgery assisted surgery were shared.Results: There was no significant difference between the two groups in the defect size, pathological type and other major clinicopathological features and operation related indicators (P > 0.05). There was comparability between the two groups, and there was no significant difference in survival outcome and follow-up time between the two groups (P > 0.05). The incidence of titanium plate displacement, deformation or exposure and facial scar deformity in DS group was significantly lower than that in CS group (P < 0.05). However, there was no significant difference in other short-term or long-term complications (P > 0.05). The incidence of dysphagia and eating disorders in DS group was significantly reduced (P < 0.05), and the speech and social functions were improved, but there was no significant difference (P > 0.05). Meanwhile, there was no significant difference in the evaluation index of facial aesthetics in this study (P > 0.05). At the same time, the total operation time, preparation time of donor site bone flap, osteotomy time and reconstruction time in DS group were significantly lower than those in traditional operation group (P < 0.05), but the plastic time and vascular anastomosis time of recipient area could not be shortened (P > 0.05). In addition, there was no significant difference in total hospitalization days between DS group and CS group (P > 0.05), but the time of ICU treatment and postoperative intravenous nutrition support in DS group was shorter than that in CS group (P < 0.05). In particular, the preoperative doctor-patient communication of DS group was more effective, and the treatment satisfaction of patients and their families was higher (P < 0.05).Conclusion: Comprehensive application of digital surgical technology in reconstruction of head and neck after tumor resection is feasible in clinical practice, which can improve the accuracy of repair, decrease some surgical complications, preserve better and improve the patient's diet and speech function, reduce the operation and hospitalization time, but also increase the treatment cost. Futhermore, it is conducive to doctor-patient communication and improve patient satisfaction.