Moellmann Henriette L, Karnatz Nadia, Degirmenci Ilkan, Gyurova Antonina, Sellin Lorenz, Rana Majeed
Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, 40225 Duesseldorf, Germany.
Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelical Hospital Bethesda, 41061 Mönchengladbach, Germany.
J Pers Med. 2022 Oct 20;12(10):1744. doi: 10.3390/jpm12101744.
In head and neck surgery, reconstruction using microvascular grafts is a successful method for functional and aesthetic restoration. Due to technological advances and medical care, the number of patients with comorbidities and diseases requiring free tissue transfer has increased. To provide adequate treatment to these patients, preoperative identification of potential risk factors is essential.
In this retrospective study, we investigated the impact of renal insufficiency on reconstruction in 251 microvascular grafts. Perioperative complications, failure rate, and outcomes serve as the basis for this evaluation.
Comparing pre- and postoperative values, there was a significant decrease in potassium and creatinine levels and a significant increase in GFR. The electrolyte changes in relation to the complication rate showed that complications were more likely to occur as potassium levels increased. As sodium levels increase, the complication rate decreases.
A preoperative value indicative of impaired renal function, such as creatinine levels, GFR, or electrolytes, did not prove to be an individual risk factor for the occurrence of graft failure in this patient population. Nevertheless, increased renal parameters are associated with increased incidence of serious complications. Therefore, these should be considered in the indication and preoperative planning.
在头颈外科手术中，使用微血管移植物进行重建是实现功能和美学修复的一种成功方法。由于技术进步和医疗护理水平提高，患有合并症且需要进行游离组织移植的患者数量有所增加。为了给这些患者提供充分的治疗，术前识别潜在风险因素至关重要。
在这项回顾性研究中，我们调查了肾功能不全对251例微血管移植物重建的影响。围手术期并发症、失败率和结果作为此次评估的依据。
比较术前和术后的值，钾和肌酐水平显著降低，肾小球滤过率显著升高。与并发症发生率相关的电解质变化表明，随着钾水平升高，并发症更有可能发生。随着钠水平升高，并发症发生率降低。
在该患者群体中，术前提示肾功能受损的值，如肌酐水平、肾小球滤过率或电解质，并未被证明是移植物失败发生的个体风险因素。然而，肾功能参数升高与严重并发症发生率增加相关。因此，在手术指征和术前规划中应考虑这些因素。
