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大腿后侧皮瓣再探讨:在肿瘤患者中的临床应用

Posterior thigh flap revisited: clinical use in oncology patients.

作者信息

Saito Akira, Minakawa Hidehiko, Saito Noriko, Isu Kazuo, Hiraga Hiroaki, Osanai Toshihisa

机构信息

Division of Plastic and Reconstructive Surgery, Hokkaido Cancer Center, Kikusui 4-2, Shiroishi-ku, Sapporo, 003-0804, Japan,

出版信息

Surg Today. 2014 Jun;44(6):1013-7. doi: 10.1007/s00595-013-0635-0. Epub 2013 Jun 8.

Abstract

PURPOSE

The posterior thigh flap is a reliable flap owing to the dependability of the inferior gluteal artery. Its utility for the reconstruction of sacral, perineal, ischial, pelvic, trochanteric and vulvar defects is well established. We herein describe the use of the flap for a variety of indications, and discuss the results with respect to postoperative complications in oncology patients.

METHODS

We reviewed nine oncology patients who were treated with pedicled posterior thigh flaps. We assessed the use of this treatment by recording the site of the defect, the type of flap used, and the presence or absence of previous surgical procedures, radiation therapy and postoperative complications.

RESULTS

Defects after resection of soft tissue sarcomas were the most common condition (n = 4), followed by skin cancers (n = 2), gastrointestinal cancers (n = 2) and radiation osteomyelitis (n = 1). Six patients (66 %) developed complications; three (33 %) were major and three (33 %) were minor. There was one case of total necrosis of the flap and two cases of partial necrosis.

CONCLUSIONS

In oncology patients, the posterior thigh flap is an excellent choice for the reconstruction of sacral, ischial, pelvic or buttock defects, since it does not cause any donor site morbidity.

摘要

目的

由于臀下动脉的可靠性,大腿后侧皮瓣是一种可靠的皮瓣。其在骶骨、会阴、坐骨、骨盆、转子和外阴缺损重建中的应用已得到充分证实。我们在此描述该皮瓣在各种适应症中的应用,并讨论肿瘤患者术后并发症的相关结果。

方法

我们回顾了9例接受带蒂大腿后侧皮瓣治疗的肿瘤患者。我们通过记录缺损部位、所用皮瓣类型以及既往手术、放疗和术后并发症的情况来评估这种治疗方法的应用。

结果

软组织肉瘤切除术后的缺损是最常见的情况(n = 4),其次是皮肤癌(n = 2)、胃肠道癌(n = 2)和放射性骨髓炎(n = 1)。6例患者(66%)出现并发症;3例(33%)为严重并发症,3例(33%)为轻微并发症。有1例皮瓣完全坏死,2例部分坏死。

结论

在肿瘤患者中,大腿后侧皮瓣是骶骨、坐骨、骨盆或臀部缺损重建的极佳选择,因为它不会导致任何供区并发症。

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