{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:01:51Z","timestamp":1787799711340,"version":"build-2784847793"},"reference-count":76,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis to compare venous couplers and hand\u2010sewn techniques for venous anastomosis in head and neck reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE and Scopus, databases were searched for relevant publications. Additionally, a manual search was performed in Google Scholar and through reference lists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Retrospective and prospective cohort studies were included. Odds ratios (ORs) and mean differences (MD) were calculated with their 95% confidence intervals (CIs) for each study comparing the 2 groups (coupler vs hand). The inverse variance method was used to combine the effect sizes from the individual studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 14,053 patients undergoing 14,270 head and neck free flap reconstructions were included from 52 studies. A total of 6080 flaps were performed using a coupling device for the venous anastomoses, while 8190 flaps were performed with the hand\u2010sewn technique. No significant difference was found for the venous thrombosis rate (OR: 1.06, 95% CI: 0.65\u20101.72), and reoperation rate (OR: 0.93, 95% CI: 0.51\u20101.70), but a significantly lower failure rate was measured for the coupler group (OR\u2009=\u20090.34, 95% CI: 0.20\u20100.58). A nonsignificant lower operative time was found for venous anastomoses (MD: \u221220.5, 95% CI: \u221251.7 to 10.7) and total surgery (MD: \u221223.7, 95% CI: \u2212344.3 to 296.8) for the coupler group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the slight advantages observed with venous couplers, the overall outcomes of both techniques are excellent, and the choice of anastomotic technique should be guided by surgeon preference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.1167","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T07:40:27Z","timestamp":1740123627000},"page":"1548-1559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Microvascular Coupling in Venous Anastomoses for Head and Neck Reconstruction: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-7785","authenticated-orcid":false,"given":"Andrea","family":"Costantino","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery AdventHealth Orlando Orlando Florida United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Uralov","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-9115","authenticated-orcid":false,"given":"Bianca Maria","family":"Festa","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Marco","family":"Pace","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uthman","family":"Alamoudi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery AdventHealth Orlando Orlando Florida United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Haughey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery AdventHealth Orlando Orlando Florida United States"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida Morsani College of Medicine Tampa Florida USA"},{"name":"Department of Surgery University of Auckland School of Medicine and Allied Health Sciences Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giannicola","family":"Iannella","sequence":"additional","affiliation":[{"name":"Department of \u2018Organi di Senso\u2019 Sapienza University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of \u2018Organi di Senso\u2019 Sapienza University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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