Mahieu, R. (2016) Head and neck reconstruction with pedicled flaps in the free flap era: a single surgeon’s experience : Is There Still a Place for Pedicled Flaps? thesis, Medicine.
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Abstract
Objective: Head and neck cancer resection results in local defects and the loss of functioning tissue, which can lead to functional impairments and disfigurement. Nowadays, the most popular method for the management of defects in the head and neck area is transposition of microvascular free flaps. However, not all patients are suitable candidates for free flap reconstruction, also not every defect requires a free flap transfer to achieve good functional results. In these cases pedicled flaps can be taken into consideration. The aim of this study is to assess whether pedicled flap reconstruction of head and neck defects are inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. Materials and Methods: This study is retrospective in nature. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015 in the AOUC Hospital, Florence Italy were analyzed. Results: A total of 93 patients, the majority with oral cancer (n=59), were included, of which 64 were pedicled flap reconstructions (69%). The results showed no significant differences in terms of functional outcome, flap necrosis and complications in each type of reconstruction. Multivariate regression analysis of flap necrosis and functional impairments showed no associated factors. Multivariate regression analysis of complicated flap healing showed that only comorbidities remained an explaining factor (p=0.019). Survival analysis and proportional hazard regression analysis regarding cancer relapse or distant metastasis, showed no significant differences in prognosis of patients concerning both types of reconstruction. Conclusion: Pedicled flaps are not significantly inferior to free flaps in the reconstruction of head and neck defects, considering functionality, complications and prognosis in this retrospective, nonrandomized study cohort.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Wedman, Dr J. |
| Supervisor name: | Deganello, Prof. A. and E.N.T. Department of AOUC, (Azienda Ospedaliero Universitari |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:59 |
| Last Modified: | 25 Jun 2020 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1919 |
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