Paridon, M.I. van (2013) Predictors of complications after oncological head and neck reconstruction using the Clavien-Dindo classification – a prospective study of 255 patients. thesis, Medicine.
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Abstract
Background: After resection of a head and neck tumor, different reconstructive techniques can be used to minimize loss of function and optimize aesthetic outcome. Postoperative complications can occur after reconstruction and are shown to lower the quality of life. However, risk factors of complications are still not identified. The Clavien-Dindo system can be used for an objective and reproducible registration of complications. The primary objective of this study is to identify predictors of complications after reconstruction in patients with head and neck cancer, using the Clavien-Dindo system. The secondary objective is to evaluate whether there are factors that influence whether a reconstruction is performed using the free flap technique. Patients and materials: In this prospective study, patients with a primary malignant tumor of the head and neck requiring surgical resection were included at four oncological centers in France. Patient and tumor characteristics, complications, and hospitalization details were collected. Potential predictors of major complications (Clavien-Dindo grade III-V), and factors that possibly influence whether or not free flap reconstruction is performed were analyzed using multiple logistic regression. Results: A total of 255 patients were included: 84 primary closure or local flap reconstructions, 28 locoregional flaps and 143 free flaps. An overall complication rate of 37.3%, major complication rate of 16.9% and mortality rate of 1.2% were found. No predictors of major complications were identified in the general study population, nor after free flap reconstruction specifically. The odds of reconstruction with a free flap were significantly decreased by both an age of ≥70 years and diabetes, and significantly increased by tumor stage IV compared to tumor stage 0-III. Conclusion: In this study no predictors for complications after reconstructive surgery were found. An age of ≥70 years, diabetes, and tumor stage were found to influence whether or not a free flap was used as reconstructive technique after head and neck tumor resection.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Post, Drs. S.F. and Werker, Prof. dr. P.M.N. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2430 |
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