Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama, 700-8558, Okayama, Japan.
Microsurgery. 2014 Feb;34(2):122-8. doi: 10.1002/micr.22157. Epub 2013 Aug 14.
Secondary reconstructive operations are needed when patients with head and neck cancers have complications such as tumor recurrence after initial treatment. These reconstructive procedures are also performed to improve the function and appearance of the head and neck region for many cancer survivors. We reviewed the patients who underwent secondary head and neck reconstruction to improve function and appearance and considered the significance of this procedure for cancer survivors, as well as its associated problems.
Among the secondary reconstruction patients, 20 patients underwent reconstruction to improve their function and/or appearance. The goal of reconstruction for the patients was functional improvement in eight cases, appearance improvement in ten cases, and both function and appearance in two cases. Chi-square analyses were performed between the secondary and primary reconstructive groups with regard to the incidence of postoperative complications.
All transferred flaps survived completely. We performed a small postoperative modification procedure in four cases. Minor complications not requiring surgical correction occurred in 2 of 20 patients. Additional operations were required owing to major postoperative complications in 2 of 20 patients. No significant associations were identified between the secondary and primary reconstructive groups with regard to postoperative complications.
The outcomes of the present report suggest that secondary reconstructive surgery is a relatively safe procedure. The decision to perform adaptation operations depends on various factors after sufficient discussion with patients.
头颈部癌症患者在初始治疗后出现肿瘤复发等并发症时,需要进行二次重建手术。这些重建手术也用于改善许多癌症幸存者的头颈部功能和外观。我们回顾了接受二次头颈部重建以改善功能和外观的患者,并考虑了该手术对癌症幸存者的意义及其相关问题。
在二次重建患者中,有 20 例患者进行了重建以改善其功能和/或外观。8 例患者的重建目的是改善功能,10 例患者的目的是改善外观,2 例患者的目的是改善功能和外观。对二次和原发性重建组的术后并发症发生率进行了卡方分析。
所有转移皮瓣均完全存活。我们对 4 例患者进行了术后小修改。20 例患者中有 2 例出现了无需手术矫正的轻微并发症。20 例患者中有 2 例因严重术后并发症需要进行额外手术。在术后并发症方面,二次和原发性重建组之间没有显著关联。
本报告的结果表明,二次重建手术是一种相对安全的手术。决定是否进行适应性手术取决于与患者充分讨论后的各种因素。