Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data

Abstract

BackgroundPostoperative complications (POCs) of moderate-advanced head and neck squamous cell carcinoma (HNSCC) after free flap reconstruction have received little attention. We investigated the risk factors that lead to POCs and their impact on management and prognosis.Patients and MethodsA single-center, prospective cohort study was conducted at Beijing Stomatological Hospital on primary HNSCC patients treated between 2015 and 2020.ResultsIn total, 399 consecutive HNSCC patients who underwent radical resection of the primary tumor and free flap reconstruction were enrolled in this study, 155(38.8%) experienced POCs. The occurrence of POCs directly led to worse short-term outcomes and poorer long-term overall survival (P=0.0056). Weight loss before the operation (P=0.097), Tumor site (P=0.002), stage T4b (P=0.016), an ACE-27 index of 2-3 (P=0.040), operation time≥8h (P=0.001) and Clindamycin as antibiotic prophylaxis (P=0.001) were significantly associated with POCs.ConclusionsThe occurrence of POCs significantly leads to worse short-term outcomes and increases the patients’ burden.

Exosomes Derived from Bone Marrow Mesenchymal Stem Cells Alleviate Ischemia-Reperfusion Injury and Promote Survival of Skin Flaps in Rats

“…Flap transplantation is an essential tissue or organ reconstruction method for cancer surgery or trauma [ 2 ]. However, partial necrosis of flaps caused by IR injury remains a common clinical problem that may lead to disastrous consequences, such as secondary surgery and increased financial burden on patients [ 28 ]. Thus, there is a need to find an effective way to improve the success rates of flap transplantation.…”

Markers of oncological prognosis in the surgical treatment of oral squamous cell carcinoma

“…В большинстве случаев описаны ретроспективные исследования, основанные на медицинской документации, базах данных и регистрах. При этом возникновение и тяжесть осложнений обычно не определены или описаны недостаточно подробно [15].…”

Bone Marrow Mesenchymal Stem Cells-derived Exosomes Promote Survival of Random Flaps in Rats through Nrf2-mediated Antioxidative Stress

“…Random flaps are widely used to repair head and neck tissue defects caused by trauma and tumor resection because of their convenient and flexible characteristics. 1 However, because a random flap has no well-known blood vessels, oxidative stress (OS), apoptosis, inflammation, and other pathological processes often occur in the local microenvironment of the distal region owing to ischemia, resulting in flap necrosis. This significantly reduces patient prognosis and also reduces the applicability of the flap.…”