Lambert Cassandre, Creff Gwenaelle, Mazoue Vincent, Coudert Paul, De Crouy Chanel Olivier, Jegoux Franck
Department of Otorhinolaryngology-Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, 35000, Rennes, France.
COSS (Chemistry Oncogenesis Stress Signaling), UMR 1242, Inserm, Univ Rennes, CLCC Eugène Marquis, Rue Bataille Flandres Dunkerque, 35042, Rennes, France.
Eur Arch Otorhinolaryngol. 2023 Feb;280(2):811-817. doi: 10.1007/s00405-022-07619-w. Epub 2022 Sep 3.
This study was designed to identify risk factors for post-operative complications in micro-anastomosed osteomyocutaneous free flaps (MOFF) and analyzed their consequences in long term.
A retrospective review of 100 MOFF realized between May 2007 and October 2019 was performed. Demographic data, perioperative management and postoperative complications were enrolled and analyzed in a multivariate model. Patients were followed for ≥ 6 months.
Major surgical complication rate was 20% with 5% of overall free flap failure rate and 6% of anastomosis salvage surgery. Risk identified for major surgical complication was alcohol consumption (p = 0.0054). Minor surgical complications occurred in 26% of patients mostly due to infections (19%). No significant risk factor was associated to minor surgical complications. Major and minor medical complication rates were, respectively, 10% and 10%. Risk identified for major medical complication were age over 70 (p = 0.0253) and history of chemotherapy (p = 0.0277). Risk identified for minor medical complication were alcohol consumption p = 0.0232) and a history of radiotherapy (p = 0.0329).
Alcoholism is an independent risk factor for the surgical complication of MOFF that must be taken into account before surgery. Patients with a history of chemotherapy, radiotherapy or who are over 70 years of age are at greater risk of postoperative medical complications and require special attention.
本研究旨在确定显微吻合骨肌皮游离皮瓣（MOFF）术后并发症的危险因素，并分析其长期后果。
对2007年5月至2019年10月期间实施的100例MOFF进行回顾性研究。收集人口统计学数据、围手术期管理和术后并发症，并纳入多变量模型进行分析。对患者进行了≥6个月的随访。
主要手术并发症发生率为20%，游离皮瓣总体失败率为5%，吻合口挽救手术率为6%。确定的主要手术并发症危险因素是饮酒（p = 0.0054）。26%的患者发生了 minor 手术并发症，主要原因是感染（19%）。未发现与 minor 手术并发症相关的显著危险因素。主要和 minor 医疗并发症发生率分别为10%和10%。确定的主要医疗并发症危险因素是年龄超过70岁（p = 0.0253）和化疗史（p = 0.0277）。确定的 minor 医疗并发症危险因素是饮酒（p = 0.0232）和放疗史（p = 0.0329）。
酗酒是MOFF手术并发症的独立危险因素，术前必须予以考虑。有化疗、放疗史或年龄超过70岁患者术后发生医疗并发症的风险更高，需要特别关注。
这里的minor暂保留英文未翻译，因为在医学语境中有时会保留特定英文术语，若有更准确的中文对应词，可自行替换。
