Zhang Xu, Li Meng-Jie, Fang Qi-Gen, Sun Chang-Fu
From the *Department of Oromaxillofacial-Head and Neck Surgery, Department of Oral and Maxillofacial Surgery School of Stomatology, China Medical University, Liaoning; and †Department of Endodontic, The Stomatological Hospital of Jilin University, Jilin, People's Republic of China.
J Craniofac Surg. 2014 May;25(3):868-71. doi: 10.1097/SCS.0000000000000443.
Our study investigated the quality of life (QoL) of Chinese patients after immediate reconstruction surgery on individuals with head and neck cancer. In addition, we compared the differences between pectoralis major myocutaneous flap (PMMF) and anterolateral thigh free flap (ALTFF). The University of Washington Quality of Life questionnaire, version 4, was used to assess the QoL. Assessments were performed at least 24 months postoperatively. A total of 110 patients' records were obtained. Among them, 86 patients completed a QoL questionnaire (78.2%). No significant differences could be found in age, primary site, T stage, N stage, and postoperative radiotherapy between PMMF and ALTFF groups. However, there were significant differences between both groups in sex, operation time, and complication. A matched analysis was performed to compare the differences in QoL between patients with head and neck cancers reconstructed with PMMF or ALTFF. Patients reconstructed with ALTFF had better shoulder but worse speech functions. There was a significant effect on the QoL of head and neck cancer patients who had undergone either PMMF or ALTFF reconstruction. The result of this study provide useful information for physicians and patients during their discussion of treatment modalities for head and neck cancers.
我们的研究调查了中国头颈癌患者即刻重建手术后的生活质量(QoL)。此外,我们比较了胸大肌肌皮瓣(PMMF)和股前外侧游离皮瓣(ALTFF)之间的差异。采用华盛顿大学生活质量问卷第4版评估生活质量。评估在术后至少24个月进行。共获取了110例患者的记录。其中,86例患者完成了生活质量问卷(78.2%)。PMMF组和ALTFF组在年龄、原发部位、T分期、N分期和术后放疗方面未发现显著差异。然而,两组在性别、手术时间和并发症方面存在显著差异。进行了匹配分析以比较用PMMF或ALTFF重建的头颈癌患者生活质量的差异。用ALTFF重建的患者肩部功能较好但言语功能较差。PMMF或ALTFF重建对头颈癌患者的生活质量有显著影响。本研究结果为医生和患者在讨论头颈癌治疗方式时提供了有用信息。