Abstract
Reconstruction with microvascular free tissue transfer is useful for wound healing and preservation of appearance and function after head and neck cancer resection. In our department, all reconstructive procedures, including flap harvesting and suturing, and microvascular anastomosis are performed by head and neck surgeons. Here, we retrospectively evaluated this practice in 104 patients （106 flaps） undergoing treatment, focusing mainly on microsurgical complications. The majority of reconstruction sites were the oral cavity and hypopharynx. In about half of the cases an anterolateral thigh flap （ALT） was used for reconstruction. The recipient vessels of choice were the superior thyroid artery and internal jugular vein in most patients. Intraoperative free flap complications occurred in 14 patients （13％）, eight of which were thrombosed arterial anastomosis. Postoperative free flap complications occurred in six patients （6％）, four of which required flap removal （4％）. While anastomotic thrombosis did not occur postoperatively, ALT perforator complications occurred in as many as four patients. Intraoperative complications were more common in salvage surgery （P＝0.059）, whereas postoperative complications were significantly correlated with postoperative infection （P＝0.016）. Although these surgical outcomes were not inferior to those of previous large-scale reports, certain improvements were considered necessary, particularly in the handling of ALT perforators.
