Microsurgical reconstruction of ablative head and neck defects in public hospital

Abstract

Introduction. The aim of the present study is to assess the results of the reconstruction of ablative head and neck defects with free flaps. Materials and methods. From 2006 to 2023 year 264 revascularization free flap (167 PE-regulatorily femoral, radial 82, 5 that rektorining, 4 blade, 3 fibula, ulna and 2 1 jejunum) were used in surgical treatment of 259 patients in age from 30 to 81 year. 199 patients underwent upfront surgery. 26 patients were operated due to recurrences. There were 8 cases of secondary reconstruction. Squamous cell carcinoma was a predominant type of tumor — 216 cases (92,7 %). In the vast majority of cases the reconstruction of upper aerodigestive tract was performed. Results. Postoperative lethality was 1,3 %. 146 patients (62,7 %) had an uncomplicated postoperative period. 87 subjects (37,3 %) had at least 1 complication, 26 of them — multiple. 40 (17,2 %) patients required return to the operating room. 18 flaps were lost, so the success rate was 92,3 %. With gaining practical experience the decrease in the rate of complications (since 52,0 to 32,3 %), operative time (since 578,8 to 402,41 minutes), days of hospitalization (since 25,79 no 19,82 days) and flap loss (since 16 to 6 %) were observed. Conclusion. The technology of free flap reconstruction can be implemented in a public hospital with an acceptable rate of complications.