Length of stay in Head and Neck Cancer surgery: An institutional protocol and experience

Long length of stay (LOS) in Head and Neck cancer (HNC) puts the recovering patient at risk of hospital acquired infections in addition to the increased cost of treatment. There is a dire need for fabricating a treatment protocol for HNC patients which can reduce this cost and without compromising with the treatment results. In this study, the authors have presented one such protocol and their experience. A retrospective study was conducted on 100 consecutive subjects operated for HNC. Parameters used in the study were the mean LOS and the complications encountered within 30 days of surgery which were divided into minor and major complications as per Clavien-Dindo system. Mean LOS in loco-regional flap/primary closure cases was 3.3 days (range = 2–15 days) and in free flap reconstruction was 8.4 days (range = 4–17 days). Complications within 30-days occurred in 42 patients. Out of these, 23 were minor complications whereas 19 were major. Re-admission was required in 7/100 subjects. Rate for readmission for free flap reconstruction cases was 15.8 % (3/19) which was comparable to other studies whereas in primary closure/loco regional flap reconstruction readmission rate was 4.9 % (4/81) which was significantly lesser than other studies. The authors were able to achieve better outcomes in locoregional flaps/primary closure cases and comparable outcomes in free flap reconstruction in terms of post-operative complications but with a significantly lesser mean LOS. •Long length of stay (LOS) in Head and Neck cancer (HNC) increases cost and risk of hospital acquired infections.•There is a dire need for a protocol to shorten the length of stay.•A retrospective study conducted on 100 subjects operated for HNC to asses postoperative complications after following a shorter LOS institutional protocol.•Better outcomes achieved in locoregional flaps cases and comparable outcomes in free flap cases to the published studies despite following the shorter LOS protocol at our institute.