University of Oulu

S. Lahtinen, P. Koivunen, T. Ala-Kokko, O. Kaarela, P. Ohtonen, P. Laurila, J.H. Liisanantti, Complications and outcome after free flap surgery for cancer of the head and neck, British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 8, 2018, Pages 684-691, ISSN 0266-4356, https://doi.org/10.1016/j.bjoms.2018.07.009

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
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
Publish Date: 2019-10-08
Description:

Abstract

We 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.

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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:
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/