Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms

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Introduction: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and nec...

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Autores principales: Olguín Joseau, Santiago, Arias, Ariel, Sánchez, Juan Carlos, Valle, Pablo, Garzón Bertola, Agustín, Peretti, Emiliano, Guzmán, Luis, Ruggieri, Marcelo
Formato: Artículo revista
Lenguaje:Inglés
Publicado: Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
Materias:
head and neck neoplasms
free tissue flaps
microsurgery
postoperative complications
risk factors
neoplasias de cabeza y cuello
colgajos libres
microcirugía
complicaciones postoperatorias
factores de riesgo
neoplasias de cabeça e pescoço
retalhos de tecido livre
microcirurgia
complicações pós-operatórias
fatores de risco
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/29523
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Revistas de la UNC de Universidad Nacional de Córdoba
id I10-R10-article-29523
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
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container_title_str Revistas de la UNC
language Inglés
format Artículo revista
topic head and neck neoplasms
free tissue flaps
microsurgery
postoperative complications
risk factors
neoplasias de cabeza y cuello
colgajos libres
microcirugía
complicaciones postoperatorias
factores de riesgo
neoplasias de cabeça e pescoço
retalhos de tecido livre
microcirurgia
complicações pós-operatórias
fatores de risco
spellingShingle head and neck neoplasms
free tissue flaps
microsurgery
postoperative complications
risk factors
neoplasias de cabeza y cuello
colgajos libres
microcirugía
complicaciones postoperatorias
factores de riesgo
neoplasias de cabeça e pescoço
retalhos de tecido livre
microcirurgia
complicações pós-operatórias
fatores de risco
Olguín Joseau, Santiago
Arias, Ariel
Sánchez, Juan Carlos
Valle, Pablo
Garzón Bertola, Agustín
Peretti, Emiliano
Guzmán, Luis
Ruggieri, Marcelo
Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
topic_facet head and neck neoplasms
free tissue flaps
microsurgery
postoperative complications
risk factors
neoplasias de cabeza y cuello
colgajos libres
microcirugía
complicaciones postoperatorias
factores de riesgo
neoplasias de cabeça e pescoço
retalhos de tecido livre
microcirurgia
complicações pós-operatórias
fatores de risco
author Olguín Joseau, Santiago
Arias, Ariel
Sánchez, Juan Carlos
Valle, Pablo
Garzón Bertola, Agustín
Peretti, Emiliano
Guzmán, Luis
Ruggieri, Marcelo
author_facet Olguín Joseau, Santiago
Arias, Ariel
Sánchez, Juan Carlos
Valle, Pablo
Garzón Bertola, Agustín
Peretti, Emiliano
Guzmán, Luis
Ruggieri, Marcelo
author_sort Olguín Joseau, Santiago
title Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
title_short Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
title_full Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
title_fullStr Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
title_full_unstemmed Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
title_sort six-year experience of microvascular free-flap reconstruction of head and neck neoplasms
description Introduction: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and neck with microvascular free-flap reconstruction. Methods: Retrospective study of patients who underwent surgery for head and neck neoplasm with microvascular free-flap reconstruction between January 2014-2020. Complications were studied at 30-days follow-up and divided into medical and flap complications. Factors independently associated with flap complication were analyzed. Results: We included 31 patients (15 men). The mean age was 60 years. Reconstruction was performed with radial-forearm flap in 74% (n=23) and with free-fibula flap in 26% (n=8). Mean surgical time was 420 minutes. Median hospital length of stay was 7 days. Medical complications were of 23%. Minor complications were of 35% and major of 32%. There was no mortality in 30-days follow-up. Flap complications were of 35%. Reintervention was of 29%, surgical site infection of 9%, dehiscence of 29% and flap loss of 9.7%.  Surgical site infection was independently associated with prolonged surgical time (Odds ratio [OR]=1.03, IC95%=0.98-1.04, p=0.02) and body mass index equal to or greater than 30 (OR=1.38, IC95%=0.84-2.26, p=0.04) while flap loss was associated with prolonged surgical time (OR=1.02, IC95%=0.99-1.04, p=0.01). Conclusion: Microsurgical free-flap reconstruction should be considered in our population in patients with large head and neck neoplasms. Preoperative assessment of the risk of postoperative complications is essential before selecting patients for this surgery.
publisher Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2021
url https://revistas.unc.edu.ar/index.php/med/article/view/29523
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first_indexed 2022-08-20T01:27:32Z
last_indexed 2022-08-20T01:27:32Z
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spelling I10-R10-article-295232021-12-30T11:59:58Z Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms Experiencia de 6 años en reconstrucción con colgajo libre microvascular en neoplasias de cabeza y cuello Experiencia de seis anos na reconstrução microvascular de retalho libre de neoplasias de cabeça y pescoço Olguín Joseau, Santiago Arias, Ariel Sánchez, Juan Carlos Valle, Pablo Garzón Bertola, Agustín Peretti, Emiliano Guzmán, Luis Ruggieri, Marcelo head and neck neoplasms free tissue flaps microsurgery postoperative complications risk factors neoplasias de cabeza y cuello colgajos libres microcirugía complicaciones postoperatorias factores de riesgo neoplasias de cabeça e pescoço retalhos de tecido livre microcirurgia complicações pós-operatórias fatores de risco Introduction: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and neck with microvascular free-flap reconstruction. Methods: Retrospective study of patients who underwent surgery for head and neck neoplasm with microvascular free-flap reconstruction between January 2014-2020. Complications were studied at 30-days follow-up and divided into medical and flap complications. Factors independently associated with flap complication were analyzed. Results: We included 31 patients (15 men). The mean age was 60 years. Reconstruction was performed with radial-forearm flap in 74% (n=23) and with free-fibula flap in 26% (n=8). Mean surgical time was 420 minutes. Median hospital length of stay was 7 days. Medical complications were of 23%. Minor complications were of 35% and major of 32%. There was no mortality in 30-days follow-up. Flap complications were of 35%. Reintervention was of 29%, surgical site infection of 9%, dehiscence of 29% and flap loss of 9.7%.  Surgical site infection was independently associated with prolonged surgical time (Odds ratio [OR]=1.03, IC95%=0.98-1.04, p=0.02) and body mass index equal to or greater than 30 (OR=1.38, IC95%=0.84-2.26, p=0.04) while flap loss was associated with prolonged surgical time (OR=1.02, IC95%=0.99-1.04, p=0.01). Conclusion: Microsurgical free-flap reconstruction should be considered in our population in patients with large head and neck neoplasms. Preoperative assessment of the risk of postoperative complications is essential before selecting patients for this surgery. Introducción: La reconstrucción con colgajo libre microvascular es una de las opciones disponibles luego de grandes resecciones de neoplasias de cabeza y cuello. Los objetivos de este estudio son identificar la morbimortalidad postoperatoria y los factores de riesgo para complicación de colgajo en pacientes sometidos a resección de neoplasias de cabeza y cuello con reconstrucción con colgajo microvascular. Métodos: Se incluyeron pacientes operados por neoplasia de cabeza y cuello con reconstrucción con colgajo libre microvascular entre 2014-2020. Las complicaciones se estudiaron a 30 días. Se analizaron los factores asociados independientemente con complicación de colgajo. Resultados: Se incluyeron 31 pacientes. La edad media fue de 60 años. La reconstrucción se realizó con colgajo radial en 76% y de peroné en 24%. La mediana de tiempo quirúrgico fue 420 minutos. La mediana de estadía hospitalaria fue 7 días. Las complicaciones médicas fueron del 24%. No hubo mortalidad en el seguimiento a 30 días. Las complicaciones del colgajo fueron del 38%. La reintervención fue del 31%, infección del sitio quirúrgico del 10%, dehiscencia del 31% y pérdida del colgajo del 10%. La infección de sitio quirúrgico se asoció independientemente con tiempo quirúrgico prolongado (Odds ratio [OR]=1,03; IC95%=0,98-1,04; p=0,02) e índice de masa corporal mayor a 30 (OR=1,38; IC95%=0,84-2,26; p=0,04) mientras que la pérdida del colgajo se asoció con tiempo quirúrgico prolongado (OR=1,02; IC95%=0,99-1,04; p=0,01). Conclusión: La reconstrucción con colgajo libre microquirúrgico debe ser considerada una de las opciones de tratamiento en nuestra población en pacientes con grandes neoplasias de cabeza y cuello. Introdução: A reconstrução microvascular do retalho livre é uma das opções disponíveis após grandes ressecções de neoplasias de cabeça e pescoço. Os objetivos deste estudo são identificar a morbimortalidade pós-operatória e os fatores de risco para complicações do retalho em pacientes submetidos à ressecção de malignidades de cabeça e pescoço com reconstrução de retalho microvascular. Métodos: Foram incluídos pacientes submetidos à cirurgia para neoplasia de cabeça e pescoço com reconstrução de retalho livre microvascular entre 2014-2020. As complicações foram estudadas aos 30 dias. Fatores associados independentemente à complicação do retalho foram analisados. Resultados: 31 pacientes foram incluídos. A idade média foi de 60 anos. A reconstrução foi realizada com retalho radial em 76% e retalho de fíbula em 24%. O tempo cirúrgico médio foi de 420 minutos. O tempo médio de internação foi de 7 dias. As complicações médicas foram de 24%. Não houve mortalidade no seguimento de 30 dias. As complicações do retalho foram de 38%. A reoperação foi de 31%, infecção do local cirúrgico de 10%, deiscência de 31% e perda de retalho de 10%. A infecção do sítio cirúrgico foi associada independentemente ao tempo cirúrgico prolongado (Odds ratio [OR]=1,03; IC95%=0,98-1,04; p=0,02) e índice de massa corporal maior que 30 (OR=1,38; IC95%=0,84-2,26; p=0,04) enquanto a perda do retalho foi associada ao tempo cirúrgico prolongado (OR=1,02; IC95%=0,99-1,04; p=0,01). Conclusão: A reconstrução com retalho microcirúrgico livre deve ser considerada uma das opções de tratamento em nossa população em pacientes com grandes neoplasias de cabeça e pescoço. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-12-28 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/29523 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. 4 (2021); 335-339 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. 4 (2021); 335-339 Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. 4 (2021); 335-339 1853-0605 0014-6722 10.31053/1853.0605.v78.n4 eng https://revistas.unc.edu.ar/index.php/med/article/view/29523/36195 https://revistas.unc.edu.ar/index.php/med/article/view/29523/35464 Derechos de autor 2021 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

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