Narushi Sugiyama1, Soshi Takao2, Etsuji Suzuki2, Yoshihiro Kimata3. 1. Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan. gmd19055@s.okayama-u.ac.jp. 2. Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan. 3. Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan.
Abstract
BACKGROUND: The risk factors for thrombus formation in anastomotic vessels in free-flap head and neck reconstruction have been previously reported. However, the evidence is inconsistent. METHODS: In total, 773 patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled at 12 institutions in Japan from 1995 to 2006. Both the resection area and the applied reconstruction method were constrained to overcome the limitations of previous studies. After the exclusion of recurrent cases, odds ratios (ORs) and 95% confidence intervals (CIs) for thrombosis were calculated in a multivariate logistic regression analysis. RESULTS: Postoperative anastomotic thrombosis developed in 23 patients (3.0%). In the multivariate analysis, the OR for thrombosis per 100-mL increase in blood loss was 1.24 (95% CI = 1.02-1.51), even after controlling for other risk factors. CONCLUSION: Our results show that the blood loss volume is an independent risk factor for thrombosis in free tissue grafts.
BACKGROUND: The risk factors for thrombus formation in anastomotic vessels in free-flap head and neck reconstruction have been previously reported. However, the evidence is inconsistent. METHODS: In total, 773 patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled at 12 institutions in Japan from 1995 to 2006. Both the resection area and the applied reconstruction method were constrained to overcome the limitations of previous studies. After the exclusion of recurrent cases, odds ratios (ORs) and 95% confidence intervals (CIs) for thrombosis were calculated in a multivariate logistic regression analysis. RESULTS:Postoperative anastomotic thrombosis developed in 23 patients (3.0%). In the multivariate analysis, the OR for thrombosis per 100-mL increase in blood loss was 1.24 (95% CI = 1.02-1.51), even after controlling for other risk factors. CONCLUSION: Our results show that the blood loss volume is an independent risk factor for thrombosis in free tissue grafts.