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Microvascular free tissue transfer after prior radiotherapy in head and neck reconstruction – A review

Publication Type : Journal Article

Publisher : Surgical Oncology

Source : Surgical Oncology, Volume 19, Number 4, p.227-234 (2010)

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Keywords : anastomosis, Animals, antineoplastic agent, Combined Modality Therapy, Free Tissue Flaps, free tissue graft, graft failure, graft patency, graft survival, head and neck cancer, Head and Neck Neoplasms, head and neck surgery, human, Humans, microsurgery, morbidity, nonhuman, organ preservation, postoperative complication, Postoperative Complications, preoperative radiotherapy, priority journal, Reconstructive Surgical Procedures, review, salvage therapy, tissue injury, treatment outcome

Campus : Kochi

Department : Head & Neck Surgery

Year : 2010

Abstract : Microvascular free tissue transfer has become an integral part of head and neck reconstruction. The role for it has widened in this era of organ preservation and surgical salvage. There are many reports on the influence of radiotherapy on the success of microvascular head and neck reconstruction, though there is a paucity of reports studying its effect after chemoradiotherapy. This article reviews the existing evidence regarding the influence of prior radiotherapy on microvascular free tissue transfer and sets a platform for further studies in the current setting of organ preservation with chemoradiotherapy and surgical salvage. Laboratory studies on animals, though demonstrating considerable tissue damage, could not find any influence of radiotherapy on the patency of the anastomosed vessels. Flap failure is reported to be more common after preoperative radiotherapy, but majority of the studies could not demonstrate a significant difference due to the lack of statistical power owing to the very high success rate of microvascular free flap surgery. Operative complications increased as the time between radiotherapy and surgery increased. There are very few reports on the outcome of free flap reconstruction after the organ preservation regimens of chemoradiotherapy. Such outcome studies would be coming forth in the near future. © 2009 Elsevier Ltd. All rights reserved.

Cite this Research Publication : K. Thankappan, “Microvascular free tissue transfer after prior radiotherapy in head and neck reconstruction - A review”, Surgical Oncology, vol. 19, pp. 227-234, 2010.

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