Jena Amitabh, Patnayak Rashmi, Sharan Rajeev, Reddy Siva Kumar, Manilal Banoth, Rao Leela Mohan Chandrasekhar
Associate Professor, Department of Surgical Oncology, Sri Venketeswar Institute of Medical Sciences, Tirupati, India.
Assistant Professor, Department of Pathology, Sri Venketeswar Institute of Medical Sciences, Tirupati, India.
J Oral Maxillofac Surg. 2014 Jan;72(1):222-31. doi: 10.1016/j.joms.2013.06.205. Epub 2013 Aug 12.
Although much has been mentioned in the literature worldwide regarding the outcome of pectoralis major myocutaneous flaps (PMMFs), hardly any studies are available that mention the outcome of PMMFs in female patients. It has been presumed that complication rates after PMMF reconstruction in female patients are higher because of the presence of more adipose tissue in the flap. The objective of this study was to analyze our data regarding the outcomes of PMMFs in female patients with oral cancer undergoing reconstruction after tumor ablation.
In this retrospective study from January 2008 to May 2012, performed in a single institution in south India, we have analyzed our data on PMMFs in 140 female patients with oral cancer. The operative technique used was essentially the same as that described originally by Ariyan. However, to preserve the deltopectoral flap area, the incision was appropriately modified in a manner as described by Schuller.
The mean age of the patients was 52.36 years, with a range from 30 to 76 years. They presented mostly with ulcers or ulceroproliferative lesions. Most of the patients had a history of tobacco and betel nut chewing. All of them underwent composite resection and reconstruction with PMMF under general anesthesia. Of the patients, 30 (21.4%) had complications, comprising infection (8), superficial flap necrosis (11), combined wound infection and superficial flap necrosis (3), total flap failure (2), and orocutaneous fistula (6).
PMMF reconstruction is a reliable and cosmetically acceptable method of reconstruction in female patients for oral cavity defects after tumor ablation.
尽管全球文献中已提及很多关于胸大肌肌皮瓣(PMMF)的治疗结果,但几乎没有研究提及女性患者中PMMF的治疗结果。据推测,女性患者PMMF重建术后的并发症发生率较高,因为皮瓣中存在更多的脂肪组织。本研究的目的是分析我们关于口腔癌女性患者在肿瘤切除术后接受PMMF重建治疗结果的数据。
在印度南部一家机构进行的这项回顾性研究中,我们分析了2008年1月至2012年5月期间140例口腔癌女性患者PMMF的数据。所采用的手术技术与Ariyan最初描述的基本相同。然而,为了保留三角胸肌皮瓣区域,按照Schuller所描述的方式对切口进行了适当修改。
患者的平均年龄为52.36岁,范围为30至76岁。她们大多表现为溃疡或溃疡增生性病变。大多数患者有吸烟和嚼槟榔史。所有患者均在全身麻醉下接受了复合切除及PMMF重建。其中30例(21.4%)患者出现并发症,包括感染(8例)、皮瓣浅层坏死(11例)、伤口感染合并皮瓣浅层坏死(3例)、皮瓣完全坏死(2例)以及口皮瘘(6例)。
PMMF重建是女性患者肿瘤切除术后口腔缺损可靠且美观的重建方法。