Complications of Metabolic Dysfunction in Head and Neck Microvascular Reconstruction.

[OBJECTIVE] To understand how metabolic health influences surgical success and improves prognostication in head and neck cancer reconstruction.

[METHODS] Retrospective cohort study. Chart review was performed on patients that underwent head and neck microvascular reconstruction by a single surgeon between 2010 and 2022. Demographic, postoperative complications, and long-term patient outcomes were collected. Patients were divided into cohorts based on the diagnosis of DM, hypertension, and BMI > 25. Those with all three comorbidities constituted the metabolic dysfunction (MetD) cohort, while the remainder group constituted the non-MetD cohort. The non-MetD group was divided into a control sub-cohort of patients with none of the three comorbidities. Outcomes were compared between groups. Postoperative complications were compared using student's -test, chi-square test, and Fisher Exact Test.

[RESULTS] Data was available for 926 patients distributed in MetD (91), non-MetD (835), and the control (226) cohorts; the MetD was significantly older ( < 0.01) with a higher BMI ( < 0.01). There were no differences in postoperative outcomes between the two cohorts. When comparing the MetD to the control, the MetD was again significantly older ( < 0.01) with a higher BMI ( < 0.01). Although the MetD had a significantly greater incidence of wound complications ( = 0.02) compared to the control, there were no other clinical differences between the two groups.

[CONCLUSION] Our study showed that within our single-surgeon population, patients with diagnosed hypertension, DM, and BMI > 25 did not experience a significantly greater incidence of most postoperative complications compared to patients without those co-morbidities after head and neck microvascular reconstruction.

[LEVEL OF EVIDENCE] Level 4.