Early Complications in Mandibular Reconstruction: Analysis Using Comprehensive Complication Index

BACKGROUND: Early postoperative complications after microvascular mandibular reconstruction impact outcomes in patients with advanced oral cancer. This study evaluates three reconstruction techniques: vascularized bone graft (VBG), mandibular reconstruction plate (MRP) with a non-osseous flap, and soft tissue flap (STF), using the Comprehensive Complication Index (CCI). METHODS: In this retrospective study of 101 patients, early postoperative complications (≤ 30 days) were assessed using the CCI, calculated from Clavien-Dindo classification grades. Differences among the three techniques were analyzed using multivariable linear regression. RESULTS: VBG was performed in younger, healthier patients. No significant differences in CCI were found among the three techniques. Multivariable analysis confirmed that non-surgical factors, such as diabetes, had greater influence on complication risks. CONCLUSIONS: Appropriate patient selection minimizes early complication risks. VBG in younger patients and technical refinements in MRP may yield complication burdens comparable to STF. TRIAL REGISTRATION: This study was registered in the UMIN Clinical Trials Registry as UMIN000056584 (http://www.umin.ac.jp/ctr).