Commando Operation

Commando Operation is a term that, within the medical field, refers to a comprehensive surgical procedure primarily used in the treatment of advanced head and neck cancer. This operation is known for its extensive approach, aiming to remove the cancerous tumor and any affected tissues around the area, including parts of the jaw, tongue, and lymph nodes in the neck. The goal of a Commando Operation is not only to excise the tumor but also to ensure the removal of potential metastatic disease pathways. Due to its complexity and the significant impact on the patient's postoperative quality of life, this procedure involves a multidisciplinary team approach, including oncologists, surgeons, radiologists, and rehabilitation specialists.

Indications

The primary indication for a Commando Operation is the presence of an advanced squamous cell carcinoma of the oral cavity or oropharynx where there is significant invasion into the surrounding tissues that cannot be adequately addressed with less invasive surgical techniques. It is often considered when the disease has spread to the lymph nodes but has not metastasized to distant organs.

Procedure

The Commando Operation involves two main components: the removal of the primary tumor and the dissection of the neck lymph nodes (neck dissection). The extent of the surgery depends on the size and location of the tumor, as well as the involvement of the lymph nodes. Reconstruction of the surgical site, often necessary due to the removal of significant tissue, is typically planned concurrently with the tumor resection to improve functional and cosmetic outcomes. This may involve the use of flaps of skin, muscle, or bone from other parts of the body.

Risks and Complications

As with any major surgery, the Commando Operation carries risks, including infection, bleeding, and complications from anesthesia. Specific to this procedure, there is a risk of significant speech and swallowing difficulties, necessitating the involvement of speech and language therapists in the postoperative care team. There may also be a need for temporary or permanent tracheostomy and feeding tubes.

Postoperative Care

Postoperative care focuses on managing pain, preventing infection, and beginning the process of rehabilitation. This includes speech and swallowing therapy, nutritional support, and, in some cases, adjuvant radiotherapy or chemotherapy to address any residual microscopic disease.

Prognosis

The prognosis following a Commando Operation depends on several factors, including the stage and grade of the tumor, the completeness of the tumor resection, and the patient's overall health. Early detection and treatment of head and neck cancers significantly improve outcomes.

See Also

• Head and Neck Cancer
• Squamous Cell Carcinoma
• Flap (surgery)
• Neck Dissection