PC12. Outcomes in Patients Undergoing Free Flap Reconstruction of the Head and Neck Region Who Underwent Revision of the Anastomosis During the Index Surgery

Abstract

PURPOSE: The difference in outcomes between patients who underwent anastomosis revision during the index surgery and those who did not. METHODS: All Patients who underwent head and neck reconstruction with free tissue transfer from September 2019 to September 2021 in a tertiary center were included. Data were collected prospectively. The cohort was divided into two groups based on anastomosis revision within the index surgery. The study outcomes were any surgical or medical complication during hospitalization, total flap compromise, partial flap compromise, and take back to surgery for vascular compromise. Medical complications recorded were venous thromboembolism, pneumonia, cardiac event, delirium, and stroke, while the surgical complication included hematoma, neck cellulitis, salivary leak, purulent neck infection, and any donor or recipient site complication. RESULTS: 302 patients were included. Out of those (n=16, 5.46%) patients underwent anastomosis revision. The mean follow-up was 2.38 ± 3.97 months from the index surgery. The rate of return to OR for vascular compromise and the rate of partial flap compromise were higher in those with a revision of the anastomosis (12.5% vs. 6.94%, p=0.4) and (n=2, 12.5% vs.=11, 3.97%, p=0.15), respectively but without statistical significance. The rate of any surgical complication on the follow-up was similar between the two groups (n=6, 40% vs. n=152, 52%, p=0.32) CONCLUSION: Patients who underwent intraoperative revision of anastomosis during surgery had a higher return to OR rate for vascular compromise and partial flap compromise, which did not reach statistical significance. However, overall surgical and medical complications rates were similar.