Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

Sao Paulo Medical Journal

Fábio Roberto Pinto²  Carina Rosa Malena¹  Christiana Maria Ribeiro Salles Vanni¹  Fábio De Aquino Capelli¹  Leandro Luongo De Matos¹  Jossi Ledo Kanda¹ 

[1] ,FMABCSão Bernardo do Campo São Paulo ,Brazil

关键词: Surgical flaps;    Reconstructive surgical procedures;    Head and neck neoplasms;    Postoperative complications;    Treatment outcome;    Retalhos cirúrgicos;    Procedimentos cirúrgicos reconstrutivos;    Neoplasias de cabeça e pescoço;    Complicações pós-operatórias;    Resultado de tratamento;   

DOI  :  10.1590/S1516-31802010000600005

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection. DESIGN AND SETTING: Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC). METHODS: Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion. RESULTS: There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (p = 0.02) and with reconstruction failure (p < 0.001). Previous oncological treatment negatively influenced the reconstruction success (p = 0.04). CONCLUSIONS: Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.

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