ArticleFrontiers in oncology2022
Unexpected Change of Surgical Plans and Contingency Strategies in Computer-Assisted Free Flap Jaw Reconstruction: Lessons Learned From 98 Consecutive Cases.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06634472 (Validation of An Artificial Intelligence-Enabled Skin Perforator Segmentation Tool in Computer-Assisted Osteocutaneous Fibular Free Flap Harvest), which is not on this map. Cited by 7 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Validation of An Artificial Intelligence-Enabled Skin Perforator Segmentation Tool in Computer-Assisted Osteocutaneous Fibular Free Flap Harvest: A Clinical Trial
Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Hybrid Reconstruction in Head and Neck Surgery: Integration of Virtual Planning, Navigation, and Robotic Microsurgery.Journal of clinical medicine · 2026Review
- Application of temporary patient-specific plate in head and neck osteocutaneous free flap reconstruction: a prospective pilot study.Frontiers in oral health · 2026Article
- Development of an Automatic Computer Program to Determine the Optimal Dental Implant Size and Position for Fibula Free Flap Surgery.Craniomaxillofacial trauma & reconstruction · 2025Article
- Adjustable Single-Osteotomy Fibular Free Flap for Anterior Mandibular Defects in Irradiated Head and Neck Cancers-A Case Series.Journal of clinical medicine · 2025Article
- A novel algorithm for streamlined surgeon-dominated patient-specific implant design in computer-assisted jaw reconstruction.3D printing in medicine · 2025Article
- Cutting-edge patient-specific surgical plates for computer-assisted mandibular reconstruction: The art of matching structures and holes in precise surgery.Frontiers in surgery · 2023Article
- Current Trends in the Reconstruction and Rehabilitation of Jaw following Ablative Surgery.Cancers · 2022Review
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComputer-assisted surgeries (CAS) are increasingly being adopted as the treatment of choice for jaw reconstructions with osseous free flaps. Although unexpected change of surgical plans remains a major concern of CAS, there are few studies focusing on this unfavorable clinical scenario. The aim of the present study was to investigate the rate of unexpected change of surgical plans and potential influential parameters, and to discuss the contingency strategies.
methodsA retrospective study was performed to evaluate all the patients who underwent computer-assisted jaw resections and osseous free flap reconstructions. The postoperative radiographs were reviewed and compared with the preoperative surgical plans. Operating records were examined to analyze the reasons for unexpected change of surgical plans and the management. The potential influential parameters for the change of surgical plans were analyzed using Fisher-exact test. The difference was regarded as statistically significant for a p-value less than 5%.
resultsFrom Nov 2014 to Oct 2021, a total of 98 consecutive computer-assisted free flap jaw reconstruction cases with osseous free flaps were included in this study. Our experience showed that 5.1% of the patients (five cases) needed intra-operative change of the surgical plans. We summarized the unexpected change of surgical plans and the contingency strategies as four clinical scenarios, including extended resection and reconstruction, shortened resection and reconstruction, modified resection without changing reconstruction, and modified reconstruction without changed resection. None of the potential influential parameters was identified as significant in relation to unexpected change of surgical plans intraoperatively.
conclusionOur experience shows that with the comprehensive methodology for computer-assisted free flap jaw reconstruction surgery planning, we can minimize the possibility of unexpected change of surgical plans during surgery. The lessons learned from our 98 consecutive cases can help beginners prevent unexpected change of surgical plans and rationalize contingency strategies in computer-assisted free flap jaw reconstruction.
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