Postoperative complications of neck dissection for head and neck squamous cell carcinoma: a systematic review and meta-analysis.

OBJECTIVE

Postoperative complications following neck dissection in head and neck squamous cell carcinoma (HNSCC) patients can significantly impact recovery and quality of life. This study aims to identify the types and incidence of these complications, thereby providing higher-level evidence to support clinical practice.

METHODS

A systematic literature search was conducted across four databases: PubMed, Scopus, Web of Science, and Academic Search Complete (EBSCO), covering studies published from January 2010 to October 2024. A random-effects model was applied to pool the data. The incidence of surgical site infection (SSI), wound dehiscence, chyle leakage, hemorrhage or hematoma, and seroma were synthesized.

RESULTS

A total of 3,483 records were retrieved, from which 15 studies met the inclusion criteria and were ultimately analyzed. Meta-analysis showed that the pooled incidence of SSI was 7.1 % (95 % CIs: 0.036-0.115, p < 0.1, I2 = 55.843 %), hemorrhage/hematoma was 5.2 % (95 % CIs: 0.025-0.087, p < 0.1, I2 = 66.754 %), seroma was 2.4 % (95 % CIs: 0.004-0.054, p > 0.1, I2 = 0.000 %), wound dehiscence was 2.2 % (95 % CIs: 0.004-0.050, p > 0.1, I2 = 41.372 %), and chyle leakage was 1.1 % (95 % CIs: 0.001-0.028, p > 0.1, I2 = 29.600 %). Nerve injury was frequently reported, although data were insufficient for meta-analysis. Other less frequently reported postoperative complications included lymphedema, fistula, and dysphagia.

CONCLUSION

The incidence of postoperative complications after neck dissection in HNSCC patients varies across studies, but SSI remains the most frequent. Future research should focus on standardizing complication reporting and exploring treatment de-escalation to improve quality of life.