title: A retrospective comparison of the morbidity and cost of different reconstructive strategies in oral and oropharyngeal carcinoma.
abstract: OBJECTIVE
  Evaluate and compare the morbidity and costs of different reconstructive strategies in oral and oropharyngeal carcinoma.
  
  
  METHODS
  Retrospective cross-sectional.
  
  
  METHODS
  One hundred twenty-seven consecutive patients treated surgically for oral and oropharyngeal carcinoma between 1990 and 1996 were evaluated. Sixty-three patients had segmental mandibulectomies with 30 plate-soft tissue reconstructions and 33 bone-soft tissue flaps. Sixty-four patients had soft-tissue-only reconstructions. The following outcome parameters were analyzed: operative time, intraoperative blood loss, postoperative admission length, ICU and coronary care unit admission length, surgical interventions for complications, re-admissions, and prolonged (>6 mo) gastrostomy tube feeding, and all costs within the disease-free interval. Means and standard deviations were calculated for continuous parameters. Differences among the three groups were analyzed using one-way analysis of variance. For discontinuous parameters, the chi-square test was applied.
  
  
  RESULTS
  Longer operative time (1.8 h) and more blood loss (150 mL) for bone-soft tissue flaps were the only statistically significant findings (P<.05) between the three groups.
  
  
  CONCLUSIONS
  There is no rationale for allowing presumed factors of morbidity or cost select for type of reconstruction in patients with oral and oropharyngeal carcinoma.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, The Toronto Hospital, University of Toronto, Ontario, Canada.
authors.forename: L E
authors.initials: LE
authors.lastname: Smeele
authors.forename: J C
authors.initials: JC
authors.lastname: Irish
authors.forename: P J
authors.initials: PJ
authors.lastname: Gullane
authors.forename: P
authors.initials: P
authors.lastname: Neligan
authors.forename: D H
authors.initials: DH
authors.lastname: Brown
authors.forename: L E
authors.initials: LE
authors.lastname: Rotstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009062:Mouth Neoplasms / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000191:economics; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000191:economics