Factors Determining Post-Operative Length of Stay and Time to Resumption of Feeding Following Free Flap Reconstruction for Oral Cancer



      Microvascular free tissue transfer reconstruction following resection of oral cancer is commonly chosen as the first line of treatment due to its superior functional outcomes. Multiple patient and surgical factors impact on the length of post-operative stay, and the time taken for patients to recommence oral feeding. This study aims to identify factors which increase the length of stay and time to resumption of feeding.


      We retrospectively evaluated 100 cases from March 2015 to October 2020 and identified variables associated with increased length of stay (LOS) and time to resumption of feeding in univariate and multivariate analysis.


      Factors found to be associated with increased LOS in multivariate analysis were increasing age, elective tracheostomy, tumours originating from the floor of mouth and mandible, longer operating time and use of fibula free flap (p<0.05). Tracheostomy, increasing age and female gender were strongly associated with delays in resumption of some types of oral feeding, and integrated critical care unit (ICCU) stays of two or more days was associated with longer time to resumption of free fluids.


      This information can be used to anticipate extensions to typical LOS, to produce cost analyses, develop individual patient risk stratification, manage patient expectations, and target use of enhanced recovery programmes.


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