Complications and outcome after free flap surgery for cancer of the head and neck |
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Author: | Lahtinen, S.1; Koivunen, P.2; Ala-Kokko, T.1; |
Organizations: |
1University of Oulu, Medical Research Center, Research Group of Surgery, Anaesthesia and Intensive Care and Department of Anaesthesiology, Oulu University Hospital, Finland 2University of Oulu, Medical Research Center, PEDEGO Research Unit, Department of Otorhinolaryngology and Head and Neck, Oulu University Hospital, Finland 3University of Oulu, Medical Research Center, Research Group of Surgery, Anaesthesia and Intensive Care and Department of Surgery, Oulu University Hospital, Finland
4University of Oulu, Division of Operative care and Medical Research Center, Oulu University Hospital, Finland
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Format: | article |
Version: | accepted version |
Access: | open |
Online Access: | PDF Full Text (PDF, 0.3 MB) |
Persistent link: | http://urn.fi/urn:nbn:fi-fe2019100831937 |
Language: | English |
Published: |
Elsevier,
2018
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Publish Date: | 2019-10-08 |
Description: |
AbstractWe retrospectively studied 136 patients who had free flap reconstruction for cancer of the head and neck at a single centre (2008–2015) to evaluate complications, assess factors associated with them, and analyse their impact on outcome. Preoperative and perioperative data, and surgical and medical complications were recorded, and the impact of the complications on duration of hospital stay and survival were assessed. A total of 86 (63%) patients had complications. Compared with those who did not, they had a higher rate of alcohol abuse (21/86, compared with 5/50, p = 0.039), longer operations (median (IQR) 565 (458–653 compared with 479 (418–556) minutes, p < 0.001), and greater intraoperative loss of blood (725 (400–1150) compared with 525 (300–800) ml, p = 0.042). Complications were more common in patients who had fibular flaps and T4 disease (22/86 compared with 4/50, p = 0.010; 47/80 compared with 16/47, p = 0.015, respectively). Those who had complications also stayed in hospital longer (median (IQR) 9 (7–12) compared with 15 (10–21) days, < 0.001). Cumulative mortality was higher in patients with late complications (those that occurred after the fourth postoperative day) (61% compared with 36%, p = 0.004). In conclusion, complications in more than half the patients were related to alcohol abuse, a more complicated intraoperative course, and fibular flaps. Complications were associated with a longer hospital stay, and survival was higher in those who did not have late complications than in those who did. see all
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Series: |
British journal of oral and maxillofacial surgery |
ISSN: | 0266-4356 |
ISSN-E: | 1532-1940 |
ISSN-L: | 0266-4356 |
Volume: | 56 |
Issue: | 8 |
Pages: | 684 - 691 |
DOI: | 10.1016/j.bjoms.2018.07.009 |
OADOI: | https://oadoi.org/10.1016/j.bjoms.2018.07.009 |
Type of Publication: |
A1 Journal article – refereed |
Field of Science: |
3126 Surgery, anesthesiology, intensive care, radiology |
Subjects: | |
Funding: |
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Copyright information: |
© 2018 Published by Elsevier Ltd. on behalf of The British Association of Oral and Maxillo facial Surgeons. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |