头颈部手术中游离皮瓣的十年经验。二次静脉吻合的必要性如何？
Ten-year experience of free flaps in head and neck surgery. How necessary is a second venous anastomosis?
作者信息
Ross Gary L, Ang Erik S W, Lannon Declan, Addison Patrick, Golger Alex, Novak Christine B, Lipa Joan E, Gullane Patrick J, Neligan Peter C
机构信息
Division of Plastic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2008 Aug;30(8):1086-9. doi: 10.1002/hed.20841.
BACKGROUND
Successful free flap surgery in the head and neck is dependent on the successful anastomosis of both artery and vein. The success of all free flaps was analyzed to determine the necessity for performing 2 venous anastomoses.
METHODS
We retrospectively analyzed a single surgeon's 10-year experience (August 1993-August 2003) in free flap reconstruction for malignant tumors of the head and neck. Four hundred ninety-two free flaps were primary reconstructions that did not require a vein graft, vein loop, or cephalic turnover procedure. Three hundred forty-five flaps had 1 venous anastomosis, and 147 flaps had 2 venous anastomoses.
RESULTS
Overall, flap success was 468 of 492 (95.1%). Successful flap reconstruction in patients undergoing 2 venous anastomoses was 145 of 147 (98.6%) compared with 323 of 345 (93.6%) in patients undergoing 1 anastomosis (p < .05).
CONCLUSION
Where possible, a second venous anastomosis should be performed in head and neck free flap reconstruction.
背景
头颈部游离皮瓣手术的成功取决于动脉和静脉的成功吻合。分析所有游离皮瓣的成功情况以确定进行2次静脉吻合的必要性。
方法
我们回顾性分析了一位外科医生在1993年8月至2003年8月期间对头颈部恶性肿瘤进行游离皮瓣重建的10年经验。492例游离皮瓣为初次重建，不需要静脉移植、静脉环或头静脉翻转术。345例皮瓣进行了1次静脉吻合，147例皮瓣进行了2次静脉吻合。
结果
总体而言，492例中有468例皮瓣成功（95.1%）。进行2次静脉吻合的患者皮瓣重建成功的有147例中的145例（98.6%），而进行1次吻合的患者为345例中的323例（93.6%）（p < .05）。
结论
在头颈部游离皮瓣重建中，应尽可能进行第二次静脉吻合。
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