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[采用不同蒂部起源的股内侧游离穿支皮瓣修复颊黏膜鳞状细胞癌切除术后缺损]

[Free medial thigh perforator flaps with various pedicle origins for the reconstruction of defect after buccal mucosa squamous cell carcinoma resection].

作者信息

Song D J, Li Z, Zhou X, Zhang Y X, Peng X W, Zhou B, Lyu C L, Peng W, Ou Y

机构信息

Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410008, China.

Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Dec 7;52(12):890-894. doi: 10.3760/cma.j.issn.1673-0860.2017.12.003.

Abstract

To explore investigate the application of free medial thigh perforator flaps with different pedicle origins in the reconstruction of defect after radical resection of buccal mucosa squamous cell carcinoma. From January 2015 to December 2016, 32 cases with buccal mucosa squamous cell carcinoma underwent radical resection and buccal mucosa defect after surgery was reconstructed by free medial thigh perforator flap at the same stage. The patients included 32 males and 5 females, ranged in age from 36 to 71 years (45.2 years on average). According to UICC stage: T4N0M0 13 cases, T4N1M0 12 cases, T3N1M0 5 cases, T3N2M0 2 cases. The course ranged from 1 to 30 months (9.6 months on average). The perforator flaps ranged from 8.0 cm×3.5 cm to 15.5 cm×6.0 cm in size, from 2.0 to 4.5 cm in thickness.The mean length of pedicles from gracilis muscle was (8.7±0.4) cm in 19 cases, the mean length of pedicles from adductor magnus muscle was (9.5±0.4) cm in 9 cases and the length of pedicles from femoral artery was (6.9±0.5) cm in 4 cases.All 44 perforator flaps survived uneventfully. The donor sites in the medial thigh were closed directly and healed well in all cases. Patients were followed up for 8 to 32 months with satisfied esthetic and functional results in reconstructed tongue, with no local recurrence. Only linear scars left in the donor sites, the functions of thighs were not affected. The free medial thigh perforator flap is an idea choice to reconstruct the defect after radical resection of buccal mucosa squamous cell carcinoma.

摘要

探讨不同蒂部起源的股内侧穿支皮瓣在颊黏膜鳞状细胞癌根治术后缺损修复中的应用。2015年1月至2016年12月,32例颊黏膜鳞状细胞癌患者行根治性切除,同期采用股内侧穿支皮瓣修复术后颊黏膜缺损。患者中男性32例,女性5例,年龄36~71岁(平均45.2岁)。根据UICC分期:T4N0M0 13例,T4N1M0 12例,T3N1M0 5例,T3N2M0 2例。病程1~30个月(平均9.6个月)。穿支皮瓣大小为8.0 cm×3.5 cm至15.5 cm×6.0 cm,厚度2.0~4.5 cm。19例股薄肌蒂平均长度为(8.7±0.4)cm,9例大收肌蒂平均长度为(9.5±0.4)cm。4例股动脉蒂长度为(6.9±0.5)cm。44块穿支皮瓣全部顺利成活。股内侧供区均直接缝合,愈合良好。患者随访8~32个月,再造舌外形及功能满意,无局部复发。供区仅留线性瘢痕,大腿功能未受影响。股内侧穿支皮瓣是颊黏膜鳞状细胞癌根治术后缺损修复的理想选择。

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