Zhang Xiangmin, Liu Folin, Lan Xiaolin, Luo Keqing, Li Shaojin
Ganzhou Institute of Cancer Research, 19, HuaYuan Qian Road, Ganzhou 341000, Jiangxi Province, People's Republic of China.
World J Surg Oncol. 2014 Aug 15;12:259. doi: 10.1186/1477-7819-12-259.
The growth of aging populations in an increasing number of countries has led to a concomitant increase in the incidence of chronic diseases. Accordingly, the proportion of older aged patients with oral cavity and oropharyngeal cancers and comorbidities has also increased. Thus, improvements must be made in the tolerance and safety of surgical procedures for these patients with complex medical conditions. In this study, we investigated combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers in terms of surgical methods, safety, and clinical outcome.
Between January 2011 and May 2012, 8 patients over the age of 65 years (7 men, 1 woman; aged 66 to 75 years (median, 69.6)) with oral cavity and oropharyngeal cancers underwent combined submandibular gland and sternocleidomastoid myocutaneous flaps for postoperative reconstruction at Ganzhou Tumor Hospital. All eight patients had comorbid cardiovascular, cerebrovascular, or chronic respiratory disease or diabetes. Clinical outcomes, complications, and tolerance to surgical treatment were observed.
Surgical treatment was successful in all eight patients. All submandibular gland flaps survived with well-mucosalized surfaces and with no complications. During the postoperative follow-up period of 12 to 28 months, no patient developed local recurrence or distant metastasis, and all had good recovery of function and local contour.
This combined reconstruction technique enables appropriate restoration of oral function, facial aesthetics and improved quality of life. Further, this technique has several advantages: it is easier to perform, reduces operation time and surgical risk, causes less surgical injury, and has minor impact on contour. The technique provides a new and safe reconstruction option for older aged patients with oral cavity and oropharyngeal cancers.
越来越多国家老年人口的增长导致慢性病发病率随之上升。因此，患有口腔和口咽癌及合并症的老年患者比例也有所增加。因此，必须提高针对这些患有复杂病症患者手术程序的耐受性和安全性。在本研究中，我们从手术方法、安全性和临床结果方面，调查了联合下颌下腺皮瓣和胸锁乳突肌肌皮瓣用于老年口腔和口咽癌患者术后重建的情况。
2011年1月至2012年5月期间，8例年龄在65岁以上（7例男性，1例女性；年龄66至75岁（中位数，69.6岁））的口腔和口咽癌患者在赣州肿瘤医院接受了联合下颌下腺和胸锁乳突肌肌皮瓣的术后重建手术。所有8例患者均患有心血管、脑血管或慢性呼吸道疾病或糖尿病合并症。观察临床结果、并发症以及对手术治疗的耐受性。
所有8例患者手术治疗均成功。所有下颌下腺皮瓣均存活，黏膜化良好，无并发症。在术后12至28个月的随访期内，无患者出现局部复发或远处转移，且所有患者功能和局部外形恢复良好。
这种联合重建技术能够适当恢复口腔功能、面部美观并改善生活质量。此外，该技术具有多个优点：操作更容易，减少手术时间和手术风险，手术损伤更小，对外形影响较小。该技术为老年口腔和口咽癌患者提供了一种新的安全重建选择。
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