Complications of Metabolic Dysfunction in Head and Neck Microvascular Reconstruction

To understand how metabolic health influences surgical success and improves prognostication in head and neck cancer reconstruction.

Retrospective cohort study. Chart review was performed on patients that underwent head and neck microvascular reconstruction by a single surgeon between 2010 and 2022. Demographic, postoperative complications, and long-term patient outcomes were collected. Patients were divided into cohorts based on the diagnosis of DM, hypertension, and BMI > 25. Those with all three comorbidities constituted the metabolic dysfunction (MetD) cohort, while the remainder group constituted the non-MetD cohort. The non-MetD group was divided into a control sub-cohort of patients with none of the three comorbidities. Outcomes were compared between groups. Postoperative complications were compared using student's t-test, chi-square test, and Fisher Exact Test.

Data was available for 926 patients distributed in MetD (91), non-MetD (835), and the control (226) cohorts; the MetD was significantly older (p < 0.01) with a higher BMI (p < 0.01). There were no differences in postoperative outcomes between the two cohorts. When comparing the MetD to the control, the MetD was again significantly older (p < 0.01) with a higher BMI (p < 0.01). Although the MetD had a significantly greater incidence of wound complications (p = 0.02) compared to the control, there were no other clinical differences between the two groups.

Our study showed that within our single-surgeon population, patients with diagnosed hypertension, DM, and BMI > 25 did not experience a significantly greater incidence of most postoperative complications compared to patients without those co-morbidities after head and neck microvascular reconstruction.

Level 4.