Outcomes of Venous End-to-Side Microvascular Anastomoses of the Head and Neck.

Authors

Matthew Stewart, Thomas Jefferson University
Perry Hammond, Thomas Jefferson UniversityFollow
Ishani Khatiwala, Thomas Jefferson UniversityFollow
Brian Swendseid, Thomas Jefferson UniversityFollow
Farshid Taghizadeh, Oregon Health and Science University
Daniel Petrisor, Oregon Health and Science University
Tingting Zhan, Thomas Jefferson UniversityFollow
Richard Goldman, Thomas Jefferson UniversityFollow
Adam Luginbuhl, Thomas Jefferson UniversityFollow
Ryan Heffelfinger, Thomas Jefferson UniversityFollow
Larissa Sweeny, Louisiana State University at Baton Rouge
Mark K Wax, Oregon Health and Science University
Joseph M. Curry, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

10-19-2020

Comments

This article is the final published version from Laryngoscope, Volume 131, Issue 6, June 2021, Pages 1286-1290.

The published version is also available at https://doi.org/10.1002/lary.29134.

Copyright © Stewart et al.

Abstract

OBJECTIVES/HYPOTHESIS: The literature on outcomes of end-to-side (ETS) anastomoses for microvascular reconstruction of the head and neck is limited. This series reviews ETS in free tissue transfer (FTT) across multiple institutions to better understand their usage and associated outcomes.

STUDY DESIGN: Retrospective review of 2482 consecutive patients across three tertiary institutions.

METHODS: Adult patients (> 18) who received a FTT from 2006 to 2019 were included.

RESULTS: Two hundred and twenty-one FTT were identified as requiring at least one ETS anastomosis. These ETS cases had a failure rate of 11.2% in comparison to 3.8% in a cohort of end-to-end (ETE) cases (P < .001). ETS cases were significantly more likely to have a prior neck dissection (P < .001), suggesting the ETS method was utilized in select circumstances. A second ETS anastomosis improved survival of the FTT (P = .006), as did utilization of a coupler over suture (P = .002). Failure due to venous thrombosis was significantly more common with one ETS anastomosis instead of two ETS anastomoses (P = .042).

CONCLUSIONS: ETS is effective but is often used as a secondary technique when ETE is not feasible; as such, in this series, ETS was associated with higher failure. A second anastomosis and the use of the coupler for completing the anastomoses were associated with lower rates of failure.

Recommended Citation

Stewart, Matthew; Hammond, Perry; Khatiwala, Ishani; Swendseid, Brian; Taghizadeh, Farshid; Petrisor, Daniel; Zhan, Tingting; Goldman, Richard; Luginbuhl, Adam; Heffelfinger, Ryan; Sweeny, Larissa; Wax, Mark K; and Curry, Joseph M., "Outcomes of Venous End-to-Side Microvascular Anastomoses of the Head and Neck." (2020). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 59.
https://jdc.jefferson.edu/otofp/59

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

33073859

Language

English