Postoperative morbidity in head and neck cancer ablative surgery followed by microsurgical free tissue transfer in the elderly

Head and Neck Free Flap Reconstruction in Patients Older than 80 Years

“…An increased rate of medical complication in the octogenarian group held true even we adjusted for comorbidities, as there was a five times greater risk of medical complication in the octogenarian cohort, suggesting that age is an independent risk factor, which concurs with other published studies. 19 These risks should be weighed with the potential benefits in quality of life and survival associated with undergoing a free tissue transfer procedure. 20 Moreover, for reconstructive aspects outside the oral cavity or oropharynx, use of regional anesthesia and local anesthesia may be a suitable alternative to general anesthesia for patients with significant comorbidities in whom general anesthesia is contraindicated.…”

Perioperative anaesthetic practice for head and neck free tissue transfer - a UK national survey

“…Several authors report pre‐operative indices such as low pre‐operative haemoglobin, low serum albumin and advanced age as independent risk factors of perioperative complications in head and neck free flap surgery, although neither age nor co‐morbidity should necessarily preclude patients from free flap surgery . A prospective analysis of 197 consecutive patients undergoing head and neck free tissue transfer concludes that the implementation of a robust multidisciplinary pre‐operative evaluation service which includes anaesthetists, nutritionists, physiotherapists and other medical specialities may reduce complications arising from pre‐exsisting medical conditions in the post‐operative period .…”

Squamous cell carcinoma of the head and neck in the elderly

“…31,39 Reconstructive surgery using microvascular free tissue transfer was also found to be feasible and safe in elderly patients, but a higher incidence of perioperative complications, especially medical, was observed, which can be attributed mainly to a higher prevalence of comorbidity among older patients. [40][41][42][43][44][45] Obviously, elderly patients have a higher perioperative morbidity and mortality rates due to underlying coexisting illnesses and often a poor performance status. Careful perioperative management is essential in order to reduce the incidence of perioperative complications.…”