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胃网膜游离皮瓣在修复不利的下咽缺损中的应用:功能评估。

Gastro-omental free flap in the reconstruction of the unfavourable hypopharyngeal defects: a functional assessment.

机构信息

Department of ENT-HNS, University Medical Center of Grenoble, Grenoble, France.

出版信息

J Plast Reconstr Aesthet Surg. 2009 Nov;62(11):1367-73. doi: 10.1016/j.bjps.2008.05.042. Epub 2008 Nov 25.

Abstract

BACKGROUND

Reconstruction flaps following major head and neck cancer surgery should consider the state of tissue at the recipient site. This study presents the cumulative experience of the use of the gastro-omental free flap (GOFF) for pharyngeal reconstruction in cases with unfavourable recipient site conditions.

METHODS

The GOFF reconstruction procedure and postoperative follow-up are described in details, and the functional results are analysed retrospectively.

RESULTS

Fifteen patients underwent GOFF reconstruction. Previous treatments included radiotherapy, chemotherapy and surgery. Postoperatively, two patients (13%) developed partial flap necrosis, and four (27%) patients developed fistula and flap stenosis. On the functional level, eight (53%) patients developed oesophageal speech at different levels of audibility, and all patients developed oral alimentation ranging from a mixed diet with supplements to a regular oral diet.

CONCLUSIONS

The GOFF is characterised by multiple survival advantages that favour its use in the presence of inhospitable recipient site conditions.

摘要

背景

头颈部癌症手术后的重建皮瓣应考虑受区组织的状态。本研究介绍了使用胃网膜游离皮瓣(GOFF)进行咽重建的累积经验,这些病例的受区条件不佳。

方法

详细描述了 GOFF 重建手术过程和术后随访,并回顾性分析了功能结果。

结果

15 名患者接受了 GOFF 重建。先前的治疗包括放疗、化疗和手术。术后,2 名患者(13%)出现部分皮瓣坏死,4 名患者(27%)出现瘘管和皮瓣狭窄。在功能方面,8 名患者(53%)在不同的可听度水平发展出食管言语,所有患者均发展出经口进食,从混合饮食加补充剂到常规经口饮食。

结论

GOFF 具有多种生存优势,有利于在受区条件不佳的情况下使用。

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