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Head and Neck Tumor Resection and Free Flap Reconstruction in Low-Volume Center
Malia Brennan1,2, Shelley Wong1,2, Paul D Faringer1,2,3
1John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Ear, Nose, & Throat Journal
|May 5, 2020
Summary
Free flap reconstructive surgery for head and neck cancer in a low-volume center achieved a 96% success rate. This study demonstrates positive outcomes and minimal complications, suggesting factors beyond surgical volume influence results.
Area of Science:
- Reconstructive Surgery
- Head and Neck Oncology
- Surgical Outcomes
Background:
- Head and neck cancer extirpation often requires complex reconstructive procedures.
- Free tissue transfer is a common method for reconstruction.
- Surgical volume is often considered a critical factor for successful outcomes.
Purpose of the Study:
- To evaluate the surgical outcomes of free tissue transfer (FTT) surgery for head and neck cancer.
- To assess the feasibility and success rates of FTT in a low-volume medical center.
- To identify complications associated with FTT in this setting.
Main Methods:
- Retrospective review of patient charts from 2015 to 2018.
- Analysis of patients undergoing free tissue transfer for head and neck cancer.
- Evaluation of free flap failure rates and related complications.
Main Results:
- A total of 27 free tissue transfer surgeries were performed (mean 6.75/year).
- The overall free flap success rate was 96%.
- Complications included partial flap necrosis (2 events), venous congestion (1), and orocutaneous fistula (2), with a low rate of total flap loss.
Conclusions:
- Low-volume centers can achieve successful outcomes in head and neck cancer reconstruction using free flap surgery.
- Factors beyond surgical volume appear to influence the success of free flap reconstructive surgery.
- These findings support the capability of smaller institutions to perform complex reconstructive procedures effectively.
