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Microvascular head and neck reconstruction in the elderly: The University of Brescia experience
Author(s) -
Piazza Cesare,
Grammatica Alberto,
Paderno Alberto,
Taglietti Valentina,
Del Bon Francesca,
Marengoni Alessandra,
Nicolai Piero
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24264
Subject(s) - medicine , contraindication , perioperative , life expectancy , head and neck , surgery , adverse effect , american society of anesthesiologists , population , alternative medicine , environmental health , pathology
Background Microvascular reconstruction in head and neck surgery is increasing in the elderly because of prolonged life expectancy. The purpose of this study was to evaluate the impact of age on outcomes after microvascular reconstruction. Methods We retrospectively reviewed 453 microvascular reconstructions and stratified patients according to age (40.8% >65 years old). Medical and surgical complications and flap success rates were evaluated according to the American Society of Anesthesiologists (ASA) score for physical status and age. Results Overall flap success and perioperative mortality were 96.1% and 0.7%, respectively. Minor medical complications were higher in the elderly (28.1% vs 15.3%; p = .001). High ASA scores affected rates of major surgical (20% vs 9.2%; p = .001) and minor medical complications (27.2% vs 13.3%; p < .001). Conclusion Microvascular reconstruction is reliable in the elderly. Age should not be considered a contraindication by itself; comorbidities play a stronger role in predicting adverse events. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1488–E1492, 2016