Impact of preoperative radiotherapy on head and neck free flap reconstruction: a report on 429 cases
| Autor: | Raphaël Hechema, J. Santini, Marc Ettaiche, Emmanuel Chamorey, M. Benatar, C S Pierre, Gilles Poissonnet, François Demard, Olivier Dassonville, Karen Benezery, Alexandre Bozec |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Fistula Free flap Comorbidity Free Tissue Flaps Young Adult Enteral Nutrition Medicine Humans Neoadjuvant therapy Aged Aged 80 and over business.industry Head and neck cancer Retrospective cohort study Pharyngeal Neoplasms Radiotherapy Dosage Length of Stay Middle Aged Plastic Surgery Procedures medicine.disease Neoadjuvant Therapy Surgery Radiation therapy Parenteral nutrition Treatment Outcome Head and Neck Neoplasms Female Mouth Neoplasms Radiotherapy Adjuvant business |
| Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 66(4) |
| ISSN: | 1878-0539 |
| Popis: | Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. Methods All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. Results In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation ( p = 0.003) and wound infection ( p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure ( p = 0.04), overall local complications ( p = 0.05), haematoma ( p = 0.04) and longer duration of enteral nutrition ( p = 0.006) and hospital stay ( p = 0.004). Conclusions Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction. |
| Databáze: | OpenAIRE |
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