Postoperative hemorrhage: Ligation of terminal branches of the carotid artery as a preventive intervention in cancer surgery?

Objective Evaluation of prophylactic ligation of terminal branches of the external carotid artery to avoid postoperative bleeding after tumor resection in squamous cell carcinoma of the oral cavity, oropharynx and hypopharynx.

Methods The clinical data of 328 patients with squamous cell carcinoma of the oral cavity, oropharynx and hypopharynx (m = 252, w = 76) in the period of 2011-19 were retrospectively evaluated. This study analyzed the effect of ligation of external carotid artery branches, especially the lingual and the facial arteries, on the frequency of postoperative bleeding.

Conclusions A total of 32 patients (10 %) were treated surgically because of secondary bleeding. In 157 patients (48 %) a vascular ligation was prophylactically performed. In patients with tumors of the oropharynx and oral cavity 61 % of the patients underwent facial artery ligation (n = 96), 22 % (n = 35) ligation of the lingual artery, and 20 % (n = 32) a combined ligation of the facial and lingual artery. Relevant secondary haemorrhage was seen in 10 % of patients with ligation of the facial artery as compared to 0 % in lingual artery ligation (p = 0.047). Secondary bleeding was seen in 6 % of patients with ligation of the lingual and facial artery. No tissue necrosis was detected as a result of ligation.

Conclusion Prophylactic occlusion of the lingual artery was associated with a lower rate of postoperative bleeding in comparison to ligation of the facial artery. Therefore it could be considered to be performed in patients with tumors in the area of supply and in patients receiving anticoagulation.

Poster-PDF A-1938.PDF

Publication History

Article published online:
10 June 2020