Abstract
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 t-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 (p < 0.01) with a higher BMI (p < 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 (p < 0.01) with a higher BMI (p < 0.01). Although the MetD had a significantly greater incidence of wound complications (p = 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.