Azovskaya, D. Y., Kulbakin, D. E., Чойнзонов, Е. Л., Shelupanov, A. A., & Kostyuchenko, E. Y. (2025). Complications after Delayed Reconstructions in Patients with Maxillofacial Tumors. Voprosy Onkologii, 70(6), 1106–1114. https://doi.org/10.37469/0507-3758-2024-70-6-1106-1114

Abstract

Aim. To evaluate the incidence of early and late complications and predisposing factors in patients with maxillofacial malignancies undergoing delayed microsurgical reconstruction.

Materials and Methods. A retrospective analysis of treatment outcomes was performed in 68 patients with maxillofacial malignancies (oral cavity and maxilla) stage T2-4aN0-2M0 (II-IVA) who underwent reconstruction with free revascularised flaps. All patients received treatment at the Department of Head and Neck Tumors of the Tomsk Research Institute of Oncology between 2009 and 2023. The patients were divided into two groups: group 1 (34 people), who underwent a single-stage (immediately after the oncological surgical stage) reconstructive surgery; and group 2 (34 people), who underwent a delayed reconstructive plastic surgery. Delayed reconstruction was performed on average 13.3 months after specialized treatment.

Results. The average follow-up time was 23 months after reconstruction. Early complications developed in 32.3 % of cases in group 1 and in 50 % of cases in group 2. When comparing early complications following delayed and simultaneous maxillary reconstructions, no statistical differences were found (p = 0.47). In contrast, there was a statistically significant difference in the mandibular reconstructions (p = 0.03). Complications were divided into those that could be managed conservatively (I-II according to the Clavien-Dindo classification: 11.7 % in group 1, 29.4 % in group 2) and those that required surgical treatment (III according to the Clavien-Dindo classification: 26.4 % in group 1, 47 % in group 2). Significant predictors of early complications in group 2 include previous radical radiation therapy, combined treatment and surgery; in group 1 it is neoadjuvant radiation therapy. However, the data obtained were not statistically significant. In this study, current and past smoking, as well as a history of cardiovascular disease, were not associated with the development of early and long-term complications. Gender and age (p > 0.05) were also found to have no effect on the incidence of complications.

Conclusion. Delayed reconstructions in patients with tumors of the maxillofacial region can achieve acceptable functional and aesthetic results, however, the high frequency of postoperative complications forces us to look for new solutions and approaches to the management of this group of patients.

https://doi.org/10.37469/0507-3758-2024-70-6-1106-1114

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