Microvascular reconstruction for head and neck cancers in high risk population: clinical outcomes and complications
Autor: | Shambhavi Singh, Neck, Bharat Bhosale, A Deshpande, Rakesh Katna, Nikhil Kalyani |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Microsurgery medicine.medical_specialty Population Oral cavity Severity of Illness Index Surgical Flaps Postoperative Complications Risk Factors medicine Humans Head and neck education Aged Retrospective Studies Aged 80 and over education.field_of_study Squamous Cell Carcinoma of Head and Neck business.industry General Medicine Gold standard (test) Middle Aged Plastic Surgery Procedures Treatment Outcome Head and Neck Neoplasms Female Surgery Radiology business Vascular Surgical Procedures |
Zdroj: | The Annals of The Royal College of Surgeons of England. 103:278-281 |
ISSN: | 1478-7083 0035-8843 |
Popis: | Introduction Microvascular reconstruction is the gold standard for reconstruction in oral cavity cancers. Age and comorbidities determine the type of reconstruction. We aimed to analyse the impact of high-risk comorbidities on perioperative morbidity. Methods This is a retrospective study of 317 patients undergoing microvascular reconstruction from January 2014 to December 2017. High risk patients were based on age, American Society of Anaesthesiologists (ASA) grade (III/IV) and Charlson comorbidity index (CCI) score >4; overall, 73 out of 317 patients were evaluated. Results Median age was 59 years. Five patients (6.8%) had complete flap failures and seven (9.5%) had minor complications (wound breakdown, bleeding, wound dehiscence, partial flap loss). ASA score of IV was significantly associated with morbidity while age >65 years and CCI >4 was not associated. The overall flap success rate was 93.2%. Conclusions A high-risk population has nearly similar outcomes for microvascular reconstruction as a younger age group. High ASA score adversely affects surgery-related outcomes. |
Databáze: | OpenAIRE |
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