title: Risk factors of thrombosis in a single method of microsurgical head and neck reconstruction: A multi-institutional study of 773 reconstructions with a free jejunal graft after total pharyngolaryngoesophagectomy for hypopharyngeal cancer.
abstract: The risk factors for thrombus formation in anastomotic vessels in free-flap head and neck reconstruction have been previously reported. However, the evidence is inconsistent.
  
  
  
  In total, 773 patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled at 12 institutions in Japan from 1995 to 2006. Both the resection area and the applied reconstruction method were constrained to overcome the limitations of previous studies. After the exclusion of recurrent cases, odds ratios (ORs) and 95% confidence intervals (CIs) for thrombosis were calculated in a multivariate logistic regression analysis.
  
  
  
  Postoperative anastomotic thrombosis developed in 23 patients (3.0%). In the multivariate analysis, the OR for thrombosis per 100-mL increase in blood loss was 1.24 (95% CI = 1.02-1.51), even after controlling for other risk factors.
  
  
  
  Our results show that the blood loss volume is an independent risk factor for thrombosis in free tissue grafts. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan. gmd19055@s.okayama-u.ac.jp.
authors.forename: Narushi
authors.initials: N
authors.lastname: Sugiyama
authors.affiliation: Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Soshi
authors.initials: S
authors.lastname: Takao
authors.affiliation: Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Etsuji
authors.initials: E
authors.lastname: Suzuki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016063:Blood Loss, Surgical; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation*; D007830:Larynx / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D037981:Neck Dissection; D016017:Odds Ratio; D061646:Operative Time; D010614:Pharynx / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*
keywords: head and neck reconstruction; microsurgery; multivariate analysis; risk factor; thrombosis