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游离股前外侧皮瓣在头颈外科手术中的应用

[Application of free anterolateral thigh flap in head and neck surgery].

作者信息

Liu Hong-Wei, Li Zhen-Dong, Dong Hui-Lei, Li Shu-Chun

机构信息

Department of Head and Neck Surgery, Liaoning Cancer Hospital, Shenyang 110042, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 May;46(5):378-81.

Abstract

OBJECTIVE

To evaluate the results of reconstruction by free anterolateral thigh flaps (ALT) after operation of head and neck tumors.

METHODS

Forty-three cases underwent the reconstruction of postoperative defects with free anterolateral thigh flaps after head and neck cancer surgeries between November 2007 and June 2010 were reviewed. Ages of the patients ranged from 40 to 81 years, with a median of 56 years; 32 males and 11 females; 23 cases of oral carcinoma, 7 cases of tonsil carcinoma, 11 cases of hypopharyngeal carcinoma, and 2 cases of head skin cancer. TNM classified as follows: no case of distant metastasis; T1 9 cases; T2 17 cases; T3 11 cases; T4 6 cases. All patients were applied with ALT to restore swallowing and respiratory functions. The mean length of blood vessel pedicles of the ALT free flaps was 12.5 (8 - 18) cm. The flaps were 4 - 15 cm in width, 5 - 25 cm in length.

RESULTS

In the 43 cases applied with ALT free flaps, 40 cases were successful and 3 cases unsuccessful. Two of the failed cases were reconstructed with pectoralis major flap. In 11 cases of hypopharyngeal carcinoma, except 3 cases with total laryngectomy, 8 cases (72.7%) had their laryngeal function been preserved.

CONCLUSIONS

The successful rate of ALT free flaps is perfect. There were no serious complication in offered areas. The flap could be shaped into various forms. ALT free flap is an ideal flap to reconstruct the defect after surgery in some head and neck tumors.

摘要

目的

评估头颈部肿瘤术后采用游离股前外侧皮瓣(ALT)重建的效果。

方法

回顾性分析2007年11月至2010年6月期间43例行头颈部癌手术后采用游离股前外侧皮瓣修复术后缺损的病例。患者年龄40至81岁,中位年龄56岁;男性32例,女性11例;口腔癌23例,扁桃体癌7例,下咽癌11例,头皮肤癌2例。TNM分期如下:无远处转移病例;T1期9例;T2期17例;T3期11例;T4期6例。所有患者均采用ALT皮瓣以恢复吞咽和呼吸功能。游离ALT皮瓣血管蒂平均长度为12.5(8 - 18)cm。皮瓣宽度4至15 cm,长度5至25 cm。

结果

43例应用游离ALT皮瓣的患者中,40例成功,3例失败。2例失败病例采用胸大肌皮瓣重建。11例下咽癌患者中,除3例行全喉切除术外,8例(72.7%)保留了喉功能。

结论

游离ALT皮瓣成功率高。供区无严重并发症。该皮瓣可塑形成各种形状。游离ALT皮瓣是修复某些头颈部肿瘤术后缺损的理想皮瓣。

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