Retrospective Study of 114 Free Flaps for Head and Neck Oncological Reconstruction in a Portuguese Tertiary Cancer Center

Authors

  • Andreia Silva Maxillofacial Surgery Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Patrícia Caixeirinho Stomatology Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Miguel Vilares Head and Neck Department. Portuguese Institute of Oncology. Lisbon.
  • Carina Semedo Head and Neck Department. Portuguese Institute of Oncology. Lisbon.
  • Mariluz Martins Head and Neck Department. Portuguese Institute of Oncology. Lisbon.
  • Carlos Zagalo Centro de Investigação Interdisciplinar Egas Moniz. Monte de Caparica.
  • Diogo Casal Plastic and Reconstructive Surgery Department. Centro Hospitalar Universitário de Lisboa Central. NOVA Medical School. Lisbon.

DOI:

https://doi.org/10.20344/amp.13734

Keywords:

Free Tissue Flaps, Head and Neck Neoplasms/surgery, Postoperative Complications, Reconstructive Surgical Procedures

Abstract

Introduction: The Portuguese experience in microsurgical reconstruction of the head and neck after oncological surgery is scantly described. The primary aim of this study was to characterize the use of microvascular reconstruction after head and neck tumor resection in a Portuguese tertiary oncological center
Material and Methods: The authors retrospectively evaluated 114 microvascular free flap procedures performed for head and neck reconstruction after oncological resection in a department of Head and Neck Surgery of a Portuguese tertiary oncological center. Patients were operated on from January 2012 to May 2018. Data on patient demographic features, tumour characteristics, perioperative complications, postoperative aesthetic and functional results, survival time and time to recurrence were extracted.
Results: Most tumours mandating microsurgical reconstruction were mucosal squamous cell carcinomas (85%) and were located in the oral region (95.6%). Around 45% of the patients had a T4a tumour and 30% a T2 tumour. Cervical metastases were present in 45.6% of the cases. The radial forearm flap and the fibular flap were the most commonly used microsurgical reconstructive options (58% and 41%, respectively). More than 80% of patients had no post-operative complications. Partial necrosis of the flap occurred in 6.1% of patients, while total flap necrosis occurred in 3.5% of cases. Aesthetic and functional results were considered at least satisfactory in all patients in which the flaps survived.
Conclusion: Microvascular reconstruction seems like a reliable treatment option in head and neck oncological surgery at our institution.

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Author Biographies

Andreia Silva, Maxillofacial Surgery Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa.

Attending Physician

Maxilo-Facial Surgery Department, Centro Hospitalar Universitário de Lisboa Central

Patrícia Caixeirinho, Stomatology Department. Centro Hospitalar Universitário de Lisboa Central. Lisboa.

Attending Physician

Stomatology Department, Centro Hospitalar Universitário de Lisboa Central

 

Miguel Vilares, Head and Neck Department. Portuguese Institute of Oncology. Lisbon.

Attending Physician

Head and Neck Department, Portuguese Institute of Oncology, Lisbon, Portugal

Carina Semedo, Head and Neck Department. Portuguese Institute of Oncology. Lisbon.

Attending Physician

Head and Neck Department, Portuguese Institute of Oncology, Lisbon, Portugal

Mariluz Martins, Head and Neck Department. Portuguese Institute of Oncology. Lisbon.

Attending Physician

Head and Neck Department, Portuguese Institute of Oncology, Lisbon, Portugal

Carlos Zagalo, Centro de Investigação Interdisciplinar Egas Moniz. Monte de Caparica.

Attending Physician

Head and Neck Department, Portuguese Institute of Oncology, Lisbon, Portugal

 

Full Professor

Centro de Investigação Interdisciplinar Egas Moniz CiiEM, Monte de Caparica, Portugal

Diogo Casal, Plastic and Reconstructive Surgery Department. Centro Hospitalar Universitário de Lisboa Central. NOVA Medical School. Lisbon.

Assistant Professor at the Anatomy Department, Nova Medical School

Attending Physician at the Plastic and Reconstructive Department and Burn Unit at Centro Hospitalar Universitário de Lisboa Central

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Published

2022-03-02

How to Cite

1.
Silva A, Caixeirinho P, Vilares M, Semedo C, Martins M, Zagalo C, Casal D. Retrospective Study of 114 Free Flaps for Head and Neck Oncological Reconstruction in a Portuguese Tertiary Cancer Center. Acta Med Port [Internet]. 2022 Mar. 2 [cited 2024 Jun. 24];35(3):192-200. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13734

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Original