Microsurgical Reconstruction for Head and Neck Cancer in Elderly Patients

Georgia-Alexandra Spyropoulou; Seng-Feng Jeng; Ching-Hua Hsieh; Antonis Tsimponis; Hsian-Shun Shih

doi:10.1055/s-0033-1357277

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2014; 30(02): 091-096
DOI: 10.1055/s-0033-1357277

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Microsurgical Reconstruction for Head and Neck Cancer in Elderly Patients

Georgia-Alexandra Spyropoulou

¹Department of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Periferiaki Odos N. Efkarpia, Thessaloniki, Greece

,

Seng-Feng Jeng

²Department of Plastic and Reconstructive Surgery, E-Da hospital, I-Shou University, Kaohsiung City, Taiwan

,

Ching-Hua Hsieh

³Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan

,

Antonis Tsimponis

¹Department of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Periferiaki Odos N. Efkarpia, Thessaloniki, Greece

,

Hsian-Shun Shih

²Department of Plastic and Reconstructive Surgery, E-Da hospital, I-Shou University, Kaohsiung City, Taiwan

› Author Affiliations

Abstract

The purpose of this study is to review our group of elderly patients and examine whether microsurgical reconstruction is safe to perform in these cases. From October 2006 to October 2009, 747 patients with head and neck cancer who underwent free flap reconstruction were divided into two groups: patients younger than 70 years (n = 714) and patients older than 70 years (n = 33). The two groups of patients were compared regarding medical comorbidities, medical/surgical complications, smoke, and alcohol consumption and outcomes. Two deaths occurred in the “elderly” (6% mortality rate) group of patients and two deaths in the “young” group of patients (0.28% mortality rate) in the immediate postoperative period (15 days postoperatively). Thus, mortality rate had a significant difference (p = 0.011) between these two groups. There was no significant difference in morbidity between these two groups of patients regarding the rate of medical complications, surgical complications, flap failure, and reexploration during our 3-month follow-up period. Mortality risk is higher in the elderly group of patients. However, there is no significant difference regarding the free flap success rate between these two groups. Thorough preoperative evaluation and preparation are critical to achieve a favorable outcome in elderly patients.

Keywords

free flap transfer - head and neck reconstruction - elderly patient

Full Text

References

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