Discussion of “Microsurgical Reconstruction Following Oncologic Resection in Pediatric Patients: A 15-Year Experience” by M. Starnes-Roubaud et al.

Excerpt

When discussing free tissue transfer in the pediatric patient, there is often a sense of reluctance on behalf of the reconstructive surgeon. Because of real or perceived differences between pediatric and adult patients, surgeons have cited microsurgical technical, patient-related, and emotional factors for this reluctance. These include small vessel size and propensity for spasticity, small body size and associated limitation in donor sites, unpredictability of growth at both the recipient and donor site, and challenges associated with the emotional wellbeing of both the patient and family. In their article “Microsurgical Reconstruction Following Oncologic Resection in Pediatric Patients: A 15-Year Experience”, Starnes-Roubaud et al.1 assert that “there is a paucity of literature and a knowledge gap regarding the safety and reliability of microvascular reconstruction in children undergoing oncologic reconstructions”. Yet, the authors present a large study with positive outcomes, supported by flap survival, complication rate, and patient long-term survival. This study appears to be a follow-up of a previously published study by Jacob et al., published in Annals of Surgical Oncology in 2010, and, as expected, the findings are similar.2 …