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股前外侧皮瓣(ALTF)在功能性舌重建中的应用及术后生活质量评估

The Use Of Anterolateral Thigh Flap (ALTF) For Functional Tongue Reconstruction With Postoperative Quality Of Live Evaluation.

作者信息

Krakowczyk Łukasz, Maciejewski Adam, Szymczyk Cezary, Wierzgoń Janusz, Półtorak Stanisław

出版信息

Pol Przegl Chir. 2015 Aug;87(8):384-8. doi: 10.1515/pjs-2015-0076.

Abstract

UNLABELLED

The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live.

MATERIAL AND METHODS

Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status.

RESULTS

The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points.

CONCLUSIONS

Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.

摘要

未标注

显微外科技术用于癌症患者口腔重建,已成为恢复口腔功能的标准治疗方法。游离股前外侧皮瓣是因鳞状细胞癌行舌全切、次全切或半切除术后重建的最优选方案之一。本研究的目的是介绍使用股前外侧游离皮瓣的重建方法并评估生活质量。

材料与方法

临床资料包括2009年至2011年间连续接受复杂手术治疗的46例舌癌患者。其中男性36例,女性10例,男女比例为3.6:1。所有患者均采用股前外侧游离皮瓣进行重建。治疗完成6个月后,根据术后功能和美学状态评估生活质量。

结果

皮瓣总体成活率为96%。8例患者(17%)出现手术并发症。42例供区一期缝合,其余4例需要植皮。46例患者均实现了可理解的言语,恢复了无限制的饮食咀嚼和吞咽功能。治疗后平均随访期为32个月。对23例患者的美学效果进行分析,结果总体良好。根据平均转换评分,生活质量>90分为优秀,76 - 90分为非常好,51 - 75分为好,25 - 50分为中等,<25分为差。

结论

股前外侧皮瓣设计灵活、蒂长且血管直径合适、供区并发症少、美学效果好,可能是功能性舌重建的理想皮瓣。

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