CLINICOPATHOLOGIC AND THERAPEUTIC RISK FACTORS FOR PERIOPERATIVE COMPLICATIONS AND PROLONGED HOSPITAL STAY IN FREE FLAP RECONSTRUCTION OF THE HEAD AND NECK

被引：168

作者：

Patel, Rajan S. ^{[1
,2
]}

McCluskey, Stuart A. ^{[3
]}

Goldstein, David P. ^{[1
]}

Minkovich, Leonid ^{[3
]}

Irish, Jonathan C. ^{[1
]}

Brown, Dale H. ^{[1
]}

Gullane, Patrick J. ^{[1
]}

Lipa, Joan E. ^{[1
]}

Gilbert, Ralph W. ^{[1
]}

机构：

[1] Univ Toronto, Dept Otolaryngol Head & Neck Surg, Dept Surg Oncol, Princess Margaret Hosp, Toronto, ON, Canada

[2] Auckland City Hosp, Dept Otolaryngol Head & Neck Surg, Auckland, New Zealand

[3] Univ Toronto, Toronto Gen Hosp, Dept Anesthet & Pain Management, Toronto, ON M5G 1L7, Canada

来源：

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2010年 / 32卷 / 10期

关键词：

head and neck cancer; free flap; reconstruction; complication; morbidity; SURGICAL-WOUND-INFECTION; FREE TISSUE TRANSFER; OROPHARYNGEAL CANCER; COMORBIDITY INDEX; SURGERY; MORBIDITY; COST; PREDICTORS; EXPERIENCE; MORTALITY;

D O I：

10.1002/hed.21331

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Background. We aimed to determine predictors of morbidity in patients undergoing microvascular free flap reconstruction of the head and neck. Methods. We prospectively evaluated 796 cases between 1999 and 2007 using univariate and multivariate analysis to determine predictors of morbidity and prolonged hospital stay. Results. Two hundred thirty-nine patients (30%) developed major complications. Age, body mass index (BMI), American Society of Anesthesiology (ASA) score, Kaplan Feinstein comorbidity index (KFI) score, preoperative hemoglobin, and tracheostomy were independent predictors of major complication. Predictors of prolonged hospital stay included age, recent weight loss, alcohol excess, ASA, KFI, preoperative hemoglobin, mucosal surgery, anesthesia duration, and crystalloid replacement volume. Conclusion. Several variables are associated with an increased risk of development of major complications following free flap reconstruction of the head and neck. Although many of these variables are irreversible, they aid risk stratification of patients undergoing free flap reconstruction, and assist clinicians in making treatment decisions, consenting, and providing patients with realistic expectations regarding their perioperative course. (C) 2010 Wiley Periodicals, Inc. Head Neck 32: 1345-1353, 2010

引用

页码：1345 / 1353

页数：9

共 42 条

[1]

[Anonymous], PLAST RECONSTR SURG

[2] A triple-blinded randomized trial comparing the hemostatic effects of large-dose 10% hydroxyethyl starch 264/0.45 versus 5% albumin during major reconstructive surgery [J].