TY - JOUR
T1 - Effect of Overlapping Operations on Outcomes in Microvascular Reconstructions of the Head and Neck
AU - Sweeny, Larissa
AU - Rosenthal, Eben L.
AU - Light, Tyler
AU - Grayson, Jessica
AU - Petrisor, Daniel
AU - Troob, Scott H.
AU - Greene, Benjamin J.
AU - Carroll, William R.
AU - Wax, Mark K.
N1 - Publisher Copyright:
© 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design: Retrospective cohort study. Setting: Tertiary care center. Subjects and Methods: Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%). Variables reviewed were as follows: defect location, indication, T classification, surgical details, duration of the operation and hospitalization, and complications (major, minor, medical). Results: Microvascular free tissue transfers performed included radial forearm (49%, n = 639), osteocutaneous radial forearm (14%, n = 182), anterior lateral thigh (12%, n = 153), fibula (10%, n = 135), rectus abdominis (7%, n = 92), latissimus dorsi (6%, n = 78), and scapula (<1%, n = 4). The mean duration of the overlapping operations was 21 minutes longer than nonoverlapping operations (P =.003). Mean duration of hospitalization was similar for nonoverlapping (9.5 days) and overlapping (9.1 days) cohorts (P =.39). There was no difference in complication rates when stratified by overlapping (45%, n = 241) and nonoverlapping (45%, n = 344) (P =.99). Subset analysis yielded similar results when minor, major, and medical complications between groups were assessed. The overall survival rate of free tissue transfers was 96%, and this was same for overlapping (96%) and nonoverlapping (96%) operations (P =.71). Conclusions: Patients had similar complication rates and durations of hospitalization for overlapping and nonoverlapping operations.
AB - Objective: To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design: Retrospective cohort study. Setting: Tertiary care center. Subjects and Methods: Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%). Variables reviewed were as follows: defect location, indication, T classification, surgical details, duration of the operation and hospitalization, and complications (major, minor, medical). Results: Microvascular free tissue transfers performed included radial forearm (49%, n = 639), osteocutaneous radial forearm (14%, n = 182), anterior lateral thigh (12%, n = 153), fibula (10%, n = 135), rectus abdominis (7%, n = 92), latissimus dorsi (6%, n = 78), and scapula (<1%, n = 4). The mean duration of the overlapping operations was 21 minutes longer than nonoverlapping operations (P =.003). Mean duration of hospitalization was similar for nonoverlapping (9.5 days) and overlapping (9.1 days) cohorts (P =.39). There was no difference in complication rates when stratified by overlapping (45%, n = 241) and nonoverlapping (45%, n = 344) (P =.99). Subset analysis yielded similar results when minor, major, and medical complications between groups were assessed. The overall survival rate of free tissue transfers was 96%, and this was same for overlapping (96%) and nonoverlapping (96%) operations (P =.71). Conclusions: Patients had similar complication rates and durations of hospitalization for overlapping and nonoverlapping operations.
KW - head and neck reconstruction
KW - overlapping operations
KW - surgical complications
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U2 - 10.1177/0194599817691746
DO - 10.1177/0194599817691746
M3 - Article
C2 - 28322117
AN - SCOPUS:85018996918
SN - 0194-5998
VL - 156
SP - 627
EP - 635
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -