Postoperative Morbidity Outcomes Associated With Superficial Temporal Versus Cervical Vessels as Recipient Vessels in Head and Neck Reconstruction: A Systematic Review and Meta-Analysis

IF 1.5 3区医学 Q3 SURGERY Microsurgery Pub Date : 2024-11-01 DOI:10.1002/micr.31255

Woo Shik Jeong, Woonhyeok Jeong

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Abstract

Background

The purpose of this meta-analysis was to compare the surgical outcomes of head and neck reconstruction via free flap surgery, with neck vessels versus superficial temporal vessels as recipient vessels.

Methods

The PubMed, Embase, and Scopus databases were systematically searched via the following keywords: (“superficial temporal” OR “temporal”) AND (“free flap” OR “free tissue transfer”) AND (“head and neck” OR “face”). The following data were extracted: first author, publication year, flap type, reconstruction region, concordant vein graft, recipient vessel, and postoperative complications, including thrombosis, partial necrosis, and flap failure. The recipient vessels were divided into two groups: the superficial temporal artery (STA)/V group and the neck group.

Results

Six hundred and thirty-five studies that met the inclusion criteria were included and reviewed systematically for a meta-analysis. Compared with the neck vessel group, the STA/V vessel group had a significantly greater risk of flap failure (odds ratio: 2.18; 95% CI: 1.32–3.60; p = 0.002), with low heterogeneity (p = 0.84; I² = 0%). However, there were no significant differences in the rates of thrombosis or partial necrosis.

Conclusions

Compared with the use of neck vessels, the use of STA/V vessels as recipient vessels for head and neck reconstruction could increase the risk of total flap necrosis. Considering these findings, surgeons should exercise caution when selecting the STV as the recipient site, and as some authors have suggested, proximal dissection may be necessary during surgery.

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以颞浅静脉和颈静脉作为头颈部重建受体血管的术后发病率结果：系统性回顾与元分析》。

背景：这项荟萃分析的目的是比较以颈部血管和颞浅血管为受体的头颈部游离皮瓣重建手术的效果：这项荟萃分析的目的是比较以颈部血管和颞浅血管作为受体血管，通过游离皮瓣手术重建头颈部的手术效果：通过以下关键词对 PubMed、Embase 和 Scopus 数据库进行系统检索：（"颞浅血管 "或 "颞浅血管"）和（"游离皮瓣 "或 "游离组织转移"）和（"头颈部 "或 "面部"）。提取以下数据：第一作者、发表年份、皮瓣类型、重建区域、吻合静脉移植、受者血管以及术后并发症，包括血栓形成、部分坏死和皮瓣失败。受体血管分为两组：颞浅动脉（STA）/V组和颈部组：结果：符合纳入标准的 635 项研究被纳入并进行了系统性审查和荟萃分析。与颈部血管组相比，STA/V 血管组皮瓣失败的风险明显更高（几率比：2.18；95% CI：1.32-3.60；P = 0.002），异质性较低（P = 0.84；I2 = 0%）。然而，血栓形成或部分坏死的发生率没有明显差异：结论：与使用颈部血管相比，使用STA/V血管作为头颈部重建的受体血管可能会增加皮瓣全坏死的风险。考虑到这些发现，外科医生在选择 STV 作为受体部位时应谨慎，正如一些学者所建议的，手术中可能需要进行近端剥离。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.