Division of Otolaryngology, Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
Head Neck. 2013 Jun;35(6):884-8. doi: 10.1002/hed.23057. Epub 2012 Jun 25.
The reconstructive surgeon is often faced with the dilemma of offering free flap reconstruction to the elderly after surgical extirpation in the head and neck due to the perception that this population tolerates these procedures poorly.
A 42-month retrospective review of all microvascular free flap reconstruction cases from a large head and neck oncology program was reviewed. A series of 278 patients met inclusion criteria and were stratified into 2 age groups: 45 to 64.9 years (n = 177) and ≥65 years (n = 101).
There was no significant difference in primary outcomes, anastomotic compromise (p = .36), unsalvageable flaps (p = .46), secondary outcomes, complicated recoveries (p = .29), or deaths within 30 days of surgery (p = .14) between the 2 groups. However, the length of postoperative recovery was increased in the elderly cohort (p = .029).
Given that outcomes were similar between young and elderly patients, surgeons should not restrict the use of free flaps based on their patients' age.
由于认为老年人群体对这些手术的耐受性较差，重建外科医生在头颈部进行手术切除后，经常面临为老年人提供游离皮瓣重建的困境。
对一个大型头颈部肿瘤项目中的所有微血管游离皮瓣重建病例进行了为期 42 个月的回顾性研究。符合纳入标准的 278 例患者被分为 2 个年龄组：45 至 64.9 岁（n = 177）和≥65 岁（n = 101）。
两组之间在主要结局（吻合口并发症，p =.36）、不可挽救的皮瓣（p =.46）、次要结局（复杂的恢复过程，p =.29）或术后 30 天内的死亡（p =.14）方面均无显著差异。然而，老年组的术后恢复时间较长（p =.029）。
鉴于年轻患者和老年患者的结果相似，外科医生不应根据患者的年龄限制游离皮瓣的使用。
