Ren Zhen-Hu, Wu Han-Jiang, Tan Hong-Yu, Wang Kai, Zhang Sheng
Resident, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Professor and Department Head, Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
J Oral Maxillofac Surg. 2015 Mar;73(3):534-40. doi: 10.1016/j.joms.2014.09.021. Epub 2014 Oct 13.
Although a promising approach, the use of anterolateral thigh (ALT) free flaps has been limited in the reconstruction of oral and maxillofacial defects in elderly patients. The aim of this study was to estimate the frequency of postoperative complications and identify factors associated with complications.
The authors designed and implemented a retrospective study on the frequency of postoperative complications in elderly patients. They enrolled a sample composed of patients who underwent ALT free flap transfers for the repair of defects created during oral and maxillofacial cancer surgery from February 2002 to March 2013. The χ(2) test, t test, and multivariate regression model were used.
A total of 1,100 patients were studied (859 men and 241 women). One hundred four patients (9.5%) were at least 70 years old (elderly group) at the time of surgery; the other 996 patients were younger than 70 years (younger group). The overall success rate of ALT free flap transfer was 97.2% (97.0% in the younger group, 99.0% in the elderly group; P > .05). The overall complication rate was 27.5% (27.2% in the younger group, 29.8% in the elderly group; P = .572). Multivariate analysis showed that operation time, American Society of Anesthesiologists class, and comorbidity were independent risk factors for postoperative complications in elderly patients.
Oral and maxillofacial reconstruction using ALT free flaps in elderly patients can achieve outcomes similar to those obtained in younger patients. Limiting the operation time is important for improving surgical outcomes.
尽管股前外侧（ALT）游离皮瓣是一种很有前景的方法，但在老年患者口腔颌面部缺损的重建中应用有限。本研究旨在评估术后并发症的发生率，并确定与并发症相关的因素。
作者设计并实施了一项关于老年患者术后并发症发生率的回顾性研究。他们纳入了一个样本，该样本由2002年2月至2013年3月期间因口腔颌面部癌症手术造成的缺损而接受ALT游离皮瓣转移修复的患者组成。使用了χ²检验、t检验和多因素回归模型。
共研究了1100例患者（859例男性和241例女性）。104例患者（9.5%）在手术时年龄至少70岁（老年组）；其他996例患者年龄小于70岁（年轻组）。ALT游离皮瓣转移的总体成功率为97.2%（年轻组为97.0%，老年组为99.0%；P>.05）。总体并发症发生率为27.5%（年轻组为27.2%，老年组为29.8%；P=.572）。多因素分析表明，手术时间、美国麻醉医师协会分级和合并症是老年患者术后并发症的独立危险因素。
老年患者使用ALT游离皮瓣进行口腔颌面部重建可取得与年轻患者相似的效果。限制手术时间对改善手术效果很重要。
