Preoperative anemia: Predictor of free flap reconstruction complications in head and neck cancer.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.4103/cjop.CJOP-D-22-00115
Cheng Hung Tu, San Fu Hong
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Abstract

Free flap reconstruction has been the mainstay among reconstruction surgeries for head and neck cancer. Intraoperative and postoperative hemoglobin (Hb) levels were both possible risk factors of flap failure and had been discussed widely. However, few investigations of preoperative Hb were seen in the previous study with its effect to flap condition remain uncertain and no conclusions in the literature. Patients who underwent free flap reconstruction after head and neck surgery in our institution between May 2014 and May 2019 were enrolled. The postoperative flap condition was observed carefully, and re-exploration was performed if necessary. We then retrospectively collected patient data with several intraoperative and postoperative indices. A total of 598 patients were enrolled in our study. The total major flap complication rate was 10.6%, with an overall success rate of 89.4%. They were predominantly male (95%), and most of them underwent free flap reconstruction for the first time (91%). A total of 81 (13%) patients received radiotherapy before reconstruction. Among all factors, the preoperative Hb level and free flap type showed significance in univariate and multivariate analyses. A previous history of radiotherapy, body mass index, nutrition status, or poorly controlled diabetes mellitus showed no significant results in either univariate or multivariate analysis. Our study showed that a lower preoperative Hb level affects free flap survival. Meanwhile, preoperative radiotherapy history has no significant influence in either univariate or multivariate analysis.

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术前贫血:头颈癌游离皮瓣重建并发症的预测因子。
游离皮瓣重建一直是头颈癌重建手术的主流。术中和术后血红蛋白(Hb)水平都是皮瓣失败的可能危险因素,已被广泛讨论。然而,在以往的研究中很少看到术前Hb的研究,其对皮瓣状况的影响仍然不确定,文献中没有结论。本研究纳入2014年5月至2019年5月在我院接受头颈部手术后游离皮瓣重建的患者。术后仔细观察皮瓣情况,必要时再次探查。然后,我们回顾性地收集了一些术中和术后指标的患者资料。我们的研究共纳入598例患者。总大皮瓣并发症发生率为10.6%,总成功率为89.4%。以男性为主(95%),大多数为首次行游离皮瓣重建(91%)。共有81例(13%)患者在重建前接受放疗。其中术前Hb水平和游离皮瓣类型在单因素和多因素分析中均具有显著性。既往放疗史、体重指数、营养状况或控制不良的糖尿病在单因素或多因素分析中均无显著结果。我们的研究表明,术前较低的Hb水平影响游离皮瓣的存活。同时,术前放疗史在单因素和多因素分析中均无显著影响。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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