title: Transfer of anterolateral thigh flaps in elderly oral cancer patients: complications in oral and maxillofacial reconstruction.
abstract: OBJECTIVE
  Although a promising approach, the use of anterolateral thigh (ALT) free flaps has been limited in the reconstruction of oral and maxillofacial defects in elderly patients. The aim of this study was to estimate the frequency of postoperative complications and identify factors associated with complications.
  
  
  METHODS
  The authors designed and implemented a retrospective study on the frequency of postoperative complications in elderly patients. They enrolled a sample composed of patients who underwent ALT free flap transfers for the repair of defects created during oral and maxillofacial cancer surgery from February 2002 to March 2013. The χ(2) test, t test, and multivariate regression model were used.
  
  
  RESULTS
  A total of 1,100 patients were studied (859 men and 241 women). One hundred four patients (9.5%) were at least 70 years old (elderly group) at the time of surgery; the other 996 patients were younger than 70 years (younger group). The overall success rate of ALT free flap transfer was 97.2% (97.0% in the younger group, 99.0% in the elderly group; P > .05). The overall complication rate was 27.5% (27.2% in the younger group, 29.8% in the elderly group; P = .572). Multivariate analysis showed that operation time, American Society of Anesthesiologists class, and comorbidity were independent risk factors for postoperative complications in elderly patients.
  
  
  CONCLUSIONS
  Oral and maxillofacial reconstruction using ALT free flaps in elderly patients can achieve outcomes similar to those obtained in younger patients. Limiting the operation time is important for improving surgical outcomes.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Zhen-Hu
authors.initials: ZH
authors.lastname: Ren
authors.affiliation: Professor and Department Head, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Han-Jiang
authors.initials: HJ
authors.lastname: Wu
authors.affiliation: Attending Physician, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Tan
authors.affiliation: Attending Physician, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China. Electronic address: zhenhuren@gmail.com.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005402:Fistula / Q000209:etiology; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009336:Necrosis; D061646:Operative Time; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012907:Smoking; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013848:Thigh / Q000601:surgery*; D060053:Transplant Donor Site / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult