OP161: Microvascular reconstruction for elderly patients after oral cancer resection

Abstract

Purpose Microvascular free tissue transfer has become an accepted and versatile method of reconstruction in the Oral & Maxillofacial region, offering a one-stage procedure and functional recovery. Many of the oral cancer patients requiring free flaps are elderly, with concomitant medical problems, including respiratory and cardiovascular compromise, and are therefore potentially at higher risk of adverse outcomes. In addition, they frequently have a history of heavy alcohol and cigarette consumption, which can compound the risks. Methods We analyzed a series of 156 intraoral free flap reconstructions and arbitrarily divided them into two groups depending on age: 60. These reconstructions were all performed for malignant lesions. Preoperative medical problems, including ischemic heart disease, hypertension, chronic obstructive pulmonary disease, peripheral vascular disease, and diabetes, were assessed and compared among the different age groups. Results The radial forearm was the most commonly used flap in the series. There was no significant difference in the distribution of the flap types across the two age groups. Ninety-one patients had preexisting medical problems. Flap failure rate was no significant difference across two age groups. Postoperative medical complications occurred in 12% and were more likely to occur with increasing age. Conclusions Our results suggest that free flap transfer is a safe technique in elderly patients with comparable surgical complications to a younger patient population. As a result of concomitant medical problems, however, postoperative medical complications are more frequent in the older age groups, with a resultant increase in length of hospital stay.