Comparison of end-to-end and end-to-side venous anastomosis in free-tissue transfer following resection of head and neck tumors

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Abstract
A comparative study was conducted of the results of venous end‐to‐end and end‐to‐side anastomosis in 948 clinical cases of microvascular free‐tissue transfers for head and neck reconstruction following tumor resection. End‐to‐side anastomosis to the internal jugular vein was achieved uneventfully in the present series, while a variety of recipient veins was used for end‐to‐end anastomosis. The incidence of thrombosis was 1.8% (15/835) in the end‐to‐end anastomosis group and 2.7% (3/113) in end‐to‐side venous anastomosis. No statistical difference was observed between the two groups. One may hesitate to perform end‐to‐side anastomosis because of unfamiliarity, concern over technical difficulty, and unreliability. As a result of our statistical analysis, we are convinced that end‐to‐side anastomosis directly to the internal jugular vein, whenever available, is the preferred procedure in microvascular free‐tissue transfers for reconstruction of the head and neck following tumor resection.