Pulmonary atelectasis after reconstruction with a rectus abdominis free tissue transfer

Mark Wax, Eben L. Rosenthal, Rodd Takaguchi, James Cohen, Peter Andersen, Neal Futran

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Atelectasis is one of the most common postoperative complications encountered in head and neck surgery. Risk factors include preexisting pulmonary disease, the procedure performed, and the length of anesthetic. Regional flaps used to reconstruct defects in the head and neck predispose to radiographic atelectasis. The rectus abdominis myocutaneous flap is usually transferred as a free tissue transfer. Harvesting the flap results in abdominal wall pain and postoperative splinting that may contribute to an increased development of atelectasis. To our knowledge, this issue has not been previously examined. Design: Retrospective review. Results: Fifty-three patients underwent rectus abdominis myocutaneous free flap reconstruction following major ablative procedures for head and neck cancer. The flap size ranged from 5 × 7 to 25 × 27 cm. Most flaps were 8 times; 15 cm. The cutaneous area transferred ranged from 35 to 600 cm2 (mean, 120 cm2). These patients were compared with a group of 53 patients who were matched for age, sex, length of the procedure, and stage of disease. Postoperative atelectasis was radiographically detected in 37 (70%) of the patients who underwent rectus abdominis myocutaneous free flap reconstruction vs 41 (77%) of the controls. Major atelectasis was not encountered in any patient in either group. Patients with a larger cutaneous paddle (>120 cm2) had a higher atelectasis score than patients with smaller cutaneous paddles (≤120 cm2) (P=.02). Conclusions: The incidence of radiographic postoperative atelectasis in patients undergoing rectus abdominis myocutaneous free tissue transfer is high. The degree of atelectasis is small, and the clinical correlation and relevance are minimal.

Original languageEnglish (US)
Pages (from-to)249-252
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume128
Issue number3
StatePublished - 2002

Fingerprint

Rectus Abdominis
Pulmonary Atelectasis
Myocutaneous Flap
Free Tissue Flaps
Skin
Neck
Head
Preexisting Condition Coverage
Abdominal Wall
Head and Neck Neoplasms
Abdominal Pain
Lung Diseases
Anesthetics
Incidence

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Pulmonary atelectasis after reconstruction with a rectus abdominis free tissue transfer. / Wax, Mark; Rosenthal, Eben L.; Takaguchi, Rodd; Cohen, James; Andersen, Peter; Futran, Neal.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 128, No. 3, 2002, p. 249-252.

Research output: Contribution to journalArticle

@article{4550250427f34c0fb0ded66978e15e64,
title = "Pulmonary atelectasis after reconstruction with a rectus abdominis free tissue transfer",
abstract = "Background: Atelectasis is one of the most common postoperative complications encountered in head and neck surgery. Risk factors include preexisting pulmonary disease, the procedure performed, and the length of anesthetic. Regional flaps used to reconstruct defects in the head and neck predispose to radiographic atelectasis. The rectus abdominis myocutaneous flap is usually transferred as a free tissue transfer. Harvesting the flap results in abdominal wall pain and postoperative splinting that may contribute to an increased development of atelectasis. To our knowledge, this issue has not been previously examined. Design: Retrospective review. Results: Fifty-three patients underwent rectus abdominis myocutaneous free flap reconstruction following major ablative procedures for head and neck cancer. The flap size ranged from 5 × 7 to 25 × 27 cm. Most flaps were 8 times; 15 cm. The cutaneous area transferred ranged from 35 to 600 cm2 (mean, 120 cm2). These patients were compared with a group of 53 patients who were matched for age, sex, length of the procedure, and stage of disease. Postoperative atelectasis was radiographically detected in 37 (70{\%}) of the patients who underwent rectus abdominis myocutaneous free flap reconstruction vs 41 (77{\%}) of the controls. Major atelectasis was not encountered in any patient in either group. Patients with a larger cutaneous paddle (>120 cm2) had a higher atelectasis score than patients with smaller cutaneous paddles (≤120 cm2) (P=.02). Conclusions: The incidence of radiographic postoperative atelectasis in patients undergoing rectus abdominis myocutaneous free tissue transfer is high. The degree of atelectasis is small, and the clinical correlation and relevance are minimal.",
author = "Mark Wax and Rosenthal, {Eben L.} and Rodd Takaguchi and James Cohen and Peter Andersen and Neal Futran",
year = "2002",
language = "English (US)",
volume = "128",
pages = "249--252",
journal = "JAMA Otolaryngology - Head and Neck Surgery",
issn = "2168-6181",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - Pulmonary atelectasis after reconstruction with a rectus abdominis free tissue transfer

AU - Wax, Mark

AU - Rosenthal, Eben L.

AU - Takaguchi, Rodd

AU - Cohen, James

AU - Andersen, Peter

AU - Futran, Neal

PY - 2002

Y1 - 2002

N2 - Background: Atelectasis is one of the most common postoperative complications encountered in head and neck surgery. Risk factors include preexisting pulmonary disease, the procedure performed, and the length of anesthetic. Regional flaps used to reconstruct defects in the head and neck predispose to radiographic atelectasis. The rectus abdominis myocutaneous flap is usually transferred as a free tissue transfer. Harvesting the flap results in abdominal wall pain and postoperative splinting that may contribute to an increased development of atelectasis. To our knowledge, this issue has not been previously examined. Design: Retrospective review. Results: Fifty-three patients underwent rectus abdominis myocutaneous free flap reconstruction following major ablative procedures for head and neck cancer. The flap size ranged from 5 × 7 to 25 × 27 cm. Most flaps were 8 times; 15 cm. The cutaneous area transferred ranged from 35 to 600 cm2 (mean, 120 cm2). These patients were compared with a group of 53 patients who were matched for age, sex, length of the procedure, and stage of disease. Postoperative atelectasis was radiographically detected in 37 (70%) of the patients who underwent rectus abdominis myocutaneous free flap reconstruction vs 41 (77%) of the controls. Major atelectasis was not encountered in any patient in either group. Patients with a larger cutaneous paddle (>120 cm2) had a higher atelectasis score than patients with smaller cutaneous paddles (≤120 cm2) (P=.02). Conclusions: The incidence of radiographic postoperative atelectasis in patients undergoing rectus abdominis myocutaneous free tissue transfer is high. The degree of atelectasis is small, and the clinical correlation and relevance are minimal.

AB - Background: Atelectasis is one of the most common postoperative complications encountered in head and neck surgery. Risk factors include preexisting pulmonary disease, the procedure performed, and the length of anesthetic. Regional flaps used to reconstruct defects in the head and neck predispose to radiographic atelectasis. The rectus abdominis myocutaneous flap is usually transferred as a free tissue transfer. Harvesting the flap results in abdominal wall pain and postoperative splinting that may contribute to an increased development of atelectasis. To our knowledge, this issue has not been previously examined. Design: Retrospective review. Results: Fifty-three patients underwent rectus abdominis myocutaneous free flap reconstruction following major ablative procedures for head and neck cancer. The flap size ranged from 5 × 7 to 25 × 27 cm. Most flaps were 8 times; 15 cm. The cutaneous area transferred ranged from 35 to 600 cm2 (mean, 120 cm2). These patients were compared with a group of 53 patients who were matched for age, sex, length of the procedure, and stage of disease. Postoperative atelectasis was radiographically detected in 37 (70%) of the patients who underwent rectus abdominis myocutaneous free flap reconstruction vs 41 (77%) of the controls. Major atelectasis was not encountered in any patient in either group. Patients with a larger cutaneous paddle (>120 cm2) had a higher atelectasis score than patients with smaller cutaneous paddles (≤120 cm2) (P=.02). Conclusions: The incidence of radiographic postoperative atelectasis in patients undergoing rectus abdominis myocutaneous free tissue transfer is high. The degree of atelectasis is small, and the clinical correlation and relevance are minimal.

UR - http://www.scopus.com/inward/record.url?scp=0036122660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036122660&partnerID=8YFLogxK

M3 - Article

C2 - 11886338

AN - SCOPUS:0036122660

VL - 128

SP - 249

EP - 252

JO - JAMA Otolaryngology - Head and Neck Surgery

JF - JAMA Otolaryngology - Head and Neck Surgery

SN - 2168-6181

IS - 3

ER -