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Successful tongue cancer surgery under general anesthesia in a 99-year-old patient in Okinawa, Japan: A case report and review of the literature

View Article: PubMed Central - PubMed

ABSTRACT

As advances in the medical field have resulted in increased life expectancy, performing surgery under general anesthesia in elderly patients has become an important issue. A 99-year-old Okinawan female was admitted to the hospital presenting with pain in the tongue. Following physical examination, a clinical diagnosis of early stage tongue cancer (T2N0Mx) was confirmed. Early stage tongue cancer is particularly easy to access for surgical resection. By contrast, later stages of tongue cancer are associated with pain, dysphagia and throat obstruction. The patient and their family agreed to surgery due to the worsening pain associated with the tumor and gave informed consent for surgery. Following consultation with a cardiologist and an anesthesiologist, the tongue tumor was surgically resected under general anesthesia. Subsequent to surgery, the patient experienced pain relief and was discharged from the hospital on day 14 post-surgery. The patient was able to maintain the same quality of life, and lived for 5 years and 2 months longer without evidence of disease, surviving to the age of 104 years old. The present case demonstrates that surgery under general anesthesia may be appropriate in patients of an advanced age, with a treatment plan that should ideally be based on careful assessment of the wishes of the patient and their family, medical risks, and benefits and economic costs of alternative treatments, in addition to consideration of the patient's culture.

No MeSH data available.


Related in: MedlinePlus

Kyphotic curvature was used intraoperatively to decrease the supine position of the patient due to kyphosis.
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f2-ol-0-0-4864: Kyphotic curvature was used intraoperatively to decrease the supine position of the patient due to kyphosis.

Mentions: Preoperative blood and urine tests reported normal blood counts, electrolytes and blood coagulation results. Bilirubin, urea and creatinine levels were unchanged following diagnostic exams and surgery. The total protein of the patient was 6.9 g/dl. An X-ray of the chest was normal, and an electrocardiogram reported the presence of sinus bradycardia. The patient was evaluated by a cardiologist and an anesthesiologist prior to selecting a treatment strategy. An echocardiogram revealed moderate pulmonic and tricuspid regurgitation, which the cardiologist assessed as age-appropriate, and a normal ejection fraction of 78%. A CT scan of the brain identified no new cerebral infarctions. The anesthesiologist determined that the patient was a good candidate for general anesthesia, and suggested that kyphotic surgical task curvature should be utilized to modify the supine surgical position due to kyphosis (Fig. 2).


Successful tongue cancer surgery under general anesthesia in a 99-year-old patient in Okinawa, Japan: A case report and review of the literature
Kyphotic curvature was used intraoperatively to decrease the supine position of the patient due to kyphosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998137&req=5

f2-ol-0-0-4864: Kyphotic curvature was used intraoperatively to decrease the supine position of the patient due to kyphosis.
Mentions: Preoperative blood and urine tests reported normal blood counts, electrolytes and blood coagulation results. Bilirubin, urea and creatinine levels were unchanged following diagnostic exams and surgery. The total protein of the patient was 6.9 g/dl. An X-ray of the chest was normal, and an electrocardiogram reported the presence of sinus bradycardia. The patient was evaluated by a cardiologist and an anesthesiologist prior to selecting a treatment strategy. An echocardiogram revealed moderate pulmonic and tricuspid regurgitation, which the cardiologist assessed as age-appropriate, and a normal ejection fraction of 78%. A CT scan of the brain identified no new cerebral infarctions. The anesthesiologist determined that the patient was a good candidate for general anesthesia, and suggested that kyphotic surgical task curvature should be utilized to modify the supine surgical position due to kyphosis (Fig. 2).

View Article: PubMed Central - PubMed

ABSTRACT

As advances in the medical field have resulted in increased life expectancy, performing surgery under general anesthesia in elderly patients has become an important issue. A 99-year-old Okinawan female was admitted to the hospital presenting with pain in the tongue. Following physical examination, a clinical diagnosis of early stage tongue cancer (T2N0Mx) was confirmed. Early stage tongue cancer is particularly easy to access for surgical resection. By contrast, later stages of tongue cancer are associated with pain, dysphagia and throat obstruction. The patient and their family agreed to surgery due to the worsening pain associated with the tumor and gave informed consent for surgery. Following consultation with a cardiologist and an anesthesiologist, the tongue tumor was surgically resected under general anesthesia. Subsequent to surgery, the patient experienced pain relief and was discharged from the hospital on day 14 post-surgery. The patient was able to maintain the same quality of life, and lived for 5 years and 2 months longer without evidence of disease, surviving to the age of 104 years old. The present case demonstrates that surgery under general anesthesia may be appropriate in patients of an advanced age, with a treatment plan that should ideally be based on careful assessment of the wishes of the patient and their family, medical risks, and benefits and economic costs of alternative treatments, in addition to consideration of the patient's culture.

No MeSH data available.


Related in: MedlinePlus