Thrombose genähter vs. gekoppelter Anastomosen bei mikrovaskulären Kopf- und Halsrekonstruktionen

Sievert M, Koch M, Goncalves M, Richter D, Tamse R, Müller SK, Gostian AO, Traxdorf M, Harreus U, Iro H (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Laryngo-Rhino-Otologie Georg Thieme Verlag

DOI: 10.1055/a-1253-8392

Abstract

Objective The Anastomotic Coupling Device for microvascular anastomoses has become widely used in free tissue transplantation. This study compares the thrombosis rate and flap failure as a function of the anastomosis technique at a large head and neck cancer center. Material and Methods Retrospective analysis of all patients receiving free flap reconstructions in the period 2001-2019. Reconstruction type, recipient vessels, number of venous anastomoses, coupler size, and operation time were investigated. We compared the rates of venous thrombosis between hand sewn and coupled anastomoses, as well as the rate of flap failure. Results A total of 403 free flap reconstructions were performed for over 17 years. The venous anastomosis was sewn in 113 flaps in single suture technique, and in 290 cases, coupler device was used. The rate of venous thrombosis requiring immediate surgical revision was 6.2 % (7/113) in the sewn group compared to 7.6 % in the coupled group (22/290; p = 0.627). With an overall success rate of 95.0 % (383/403), the rate of flap failure was 3.6 % (4/113) and 5.5 % (16/290; p = 0.421), respectively. Surgical time is comparable with 680 ± 144 minutes in the hand-sewn group and 688 ± 167 minutes in the coupled group (p = 0.678). Conclusions With similar success rates, the coupler device is an effective alternative to venous anastomosis in single suture technique. Due to the generally low rate of pedicle thrombosis in both groups, we cannot separate the influence of the anastomosis technique from possible interfering variables.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Maximilian Traxdorf Medizinische Fakultät Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde

Involved external institutions

Asklepios Kliniken DE Germany (DE)

How to cite

APA:

Sievert, M., Koch, M., Goncalves, M., Richter, D., Tamse, R., Müller, S.K.,... Iro, H. (2020). Thrombose genähter vs. gekoppelter Anastomosen bei mikrovaskulären Kopf- und Halsrekonstruktionen. Laryngo-Rhino-Otologie. https://doi.org/10.1055/a-1253-8392

MLA:

Sievert, Matti, et al. "Thrombose genähter vs. gekoppelter Anastomosen bei mikrovaskulären Kopf- und Halsrekonstruktionen." Laryngo-Rhino-Otologie (2020).

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