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口腔和口咽癌患者显微外科重建后的临床结局及与健康相关的生活质量

Clinical outcome and health-related quality-of-life following microsurgical reconstruction in patients with oral and oropharyngeal cancer.

作者信息

Al-Hayder Shems, Elberg Jens Jørgen, Charabi Birgitte

机构信息

a Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark.

b Department of Plastic Surgery, Breast Surgery, and Burns Treatment, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark.

出版信息

Acta Otolaryngol. 2017 May;137(5):541-545. doi: 10.1080/00016489.2016.1249945. Epub 2016 Nov 4.

Abstract

CONCLUSION

Radial forearm free flap (RFFF) and fibula free flap (FFF) provide high safety and reliability with low incidence of free flap failure and an acceptable level of complications and health-related quality-of-life (HRQoL).

OBJECTIVES

To determine the clinical outcomes and long-term HRQoL in patients with oral or oropharyngeal cancer following free flap reconstruction.

METHODS

A retrospective review of medical records and self-administered HRQoL questionnaires, EORTC QLQ-C30, and -H&N35. All patients who underwent surgery for oral or oropharyngeal cancer followed by primary reconstruction by RFFF or FFF at Rigshospitalet between September 2001 and November 2011 were included.

RESULTS

The study comprised 19 patients still alive out of 61 patients. The free flap success rate was 94.7%. Early post-operative complications occurred in 11 patients (57.9%); however, only three cases (15.8%) required re-surgery. Nine patients (47.4%) developed late complications, including mandibular osteoradionecrosis in six cases (31.6%). Most patients obtained acceptable values of global quality-of-life and relatively high scores on the functional scales.

摘要

结论

桡侧前臂游离皮瓣(RFFF)和腓骨游离皮瓣(FFF)具有高度安全性和可靠性,游离皮瓣失败发生率低,并发症及与健康相关的生活质量(HRQoL)水平可接受。

目的

确定口腔或口咽癌患者游离皮瓣重建后的临床结局及长期HRQoL。

方法

对病历及自行填写的HRQoL问卷(EORTC QLQ-C30和-H&N35)进行回顾性分析。纳入2001年9月至2011年11月在里格霍斯皮塔尔接受口腔或口咽癌手术,随后采用RFFF或FFF进行一期重建的所有患者。

结果

61例患者中有19例仍存活。游离皮瓣成功率为94.7%。11例患者(57.9%)发生早期术后并发症;然而,仅3例(15.8%)需要再次手术。9例患者(47.4%)出现晚期并发症,其中6例(31.6%)发生下颌骨放射性骨坏死。大多数患者的总体生活质量值可接受,功能量表得分相对较高。

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