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Impact of Body Mass Index on Surgical Outcomes in Oncologic Microvascular Head and Neck Reconstruction

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Despite increasing recognition, obesity continues to represent a major health issue for millions of people in the USA and worldwide. There is a paucity in the literature regarding the effect of body mass index (BMI) on microsurgical head and neck reconstruction. The present study hypothesized that high BMI is predictive of postoperative recipient- and donor-site complications with longer operative times.

Patients and Methods

Retrospective review of patients who underwent free flap surgery for head and neck reconstruction was performed between January 2005 and December 2018. Patients were categorized into four groups based on BMI: < 20 kg/m2, 20–30 kg/m2, 30–40 kg/m2, and ≥ 40 kg/m2. Patient characteristics and surgical outcomes were compared between the four groups.

Results

Overall, 4000 free flap surgeries were included in the present study, performed on 3753 patients, of whom 9.9% had a BMI < 20 kg/m2, 64.9% had a BMI between 20 and 30 kg/m2, 21.6% had a BMI between 30 and 40 kg/m2, and 3.6% had a BMI ≥ 40 kg/m2. After adjusting for potential confounders, multivariate analysis showed no association between BMI and any complication, major recipient complications, or total flap loss. However, multivariate linear regression model showed BMI 30–40 kg/m2 and BMI ≥ 40 kg/m2 to be independently associated with longer operative times compared with BMI < 20 kg/m2.

Conclusion

Obesity and high BMI increase operative times; however, with meticulous surgical technique and diligent postoperative care, microvascular head and neck reconstructions can be performed safely and reliably in the majority of patients regardless of BMI with similar overall, recipient-site, and donor-site complications.

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Malke Asaad MD, Christopher Yao MD, Praneeth Kambhampati BS, David Mitchell BS, Jun Liu PhD, Peirong Yu MD, Matthew M. Hanasono MD & Edward I. Chang MD, FACS

  2. Baylor College of Medicine, Houston, TX, USA

    Praneeth Kambhampati BS

  3. McGovern School of Medicine, Houston, TX, USA

    David Mitchell BS

  4. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Carol M Lewis MD, MPH

Authors
  1. Malke Asaad MD
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  2. Christopher Yao MD
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  3. Praneeth Kambhampati BS
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  4. David Mitchell BS
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  6. Carol M Lewis MD, MPH
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  9. Edward I. Chang MD, FACS
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Correspondence to Edward I. Chang MD, FACS.

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Asaad, M., Yao, C., Kambhampati, P. et al. Impact of Body Mass Index on Surgical Outcomes in Oncologic Microvascular Head and Neck Reconstruction. Ann Surg Oncol 29, 5109–5121 (2022). https://doi.org/10.1245/s10434-022-11542-z

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  • DOI: https://doi.org/10.1245/s10434-022-11542-z

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