title: Factors Influencing Postoperative Complications in Reconstructive Microsurgery for Head and Neck Cancer.
abstract: OBJECTIVE
  The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer.
  
  
  METHODS
  This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed. Major complications included flap failure and life-threatening events. Minor complications were defined as requiring only routine wound care or conservative treatments. To evaluate group differences, the χ2test was applied for categorical variables and the Mann-Whitney U test was used for continuous variables.
  
  
  RESULTS
  In total, 158 patients (145 men [91.8%], 13 women [8.2%]) were included in this study. The mean age of the study population was 52.4 years (range, 34 to 84 yr). The mean body mass index (BMI) was 23.71 kg/m2. Most patients (93.7%) had a history of cigarette smoking. Some patients had diabetes (20.3%) and hypertension (31.6%). The percentage of patients who underwent radiotherapy before surgery was 19.6%. The percentage whose flap required a salvage operation was 8.9%. The success rate of the microvascular surgeries was 95.6%. The major complication rate was 6.3% and the minor complication rate was 27.8%. No surgical mortality was noted.
  
  
  CONCLUSIONS
  In these patients, poor nutrition status, indicated by low BMI and low albumin level, was associated with a greater tendency to develop postoperative complications. Patients who had diabetes or who had received radiotherapy before surgery had a high risk for major complications. A large skin paddle seemed to be an influencing factor for minor complications, such as wound dehiscence and superficial loss of flaps.
authors.affiliation: Resident, Division of Plastic and Reconstructive Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Shih-Lun
authors.initials: SL
authors.lastname: Lo
authors.affiliation: Attending Physician, Division of Plastic and Reconstructive Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Yu-Hsiu
authors.initials: YH
authors.lastname: Yen
authors.affiliation: Attending Physician, Division of Plastic and Reconstructive Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Pi-Jung
authors.initials: PJ
authors.lastname: Lee
authors.affiliation: Attending Physician, Division of Plastic and Reconstructive Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Chih-Ho Charles
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Division Head, Division of Plastic and Reconstructive Surgery, Cathay General Hospital, Taipei, Taiwan. Electronic address: pkman9335@msn.com.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Pu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome