Kwon Soo-Ha, Lee Che-Hsiung, Hsu Angela Ting-Wei, Shafarenko Mark, Omar Usama Farghaly, Tzou Chieh-Han, Roka-Palkovits Julia, Beltrán P Aldo G, Liakos Dimitri, Chang Tommy Nai-Jen
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan.
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
J Reconstr Microsurg. 2018 Jul;34(6):413-419. doi: 10.1055/s-0038-1626696. Epub 2018 Feb 2.
The best reconstructive strategy for upper lip defects is still in debate. The purpose of this study was to analyze the decisions made by international microsurgeons, who were participated through online questionnaire, distributed by email and social media network.
A case of a two-thirds upper lip oncologic defect was presented via an online questionnaire and 402 microsurgeons replied their treatment options. The data were then analyzed according to the geographic area, microsurgical fellowship, seniority, and subspecialty. All the data were analyzed using SPSS 22.
A total of 27.7% of microsurgeons chose a free flap, while 72.3% chose a local/pedicle flap as their preferred method for reconstruction. The most common choice of free and local/pedicle flaps was radial forearm (73.6%) and Abbé (36.2%), respectively. The microsurgeons in Europe preferred local/pedicle flaps than free flap when compared with Middle/South America, Asia-Pacific, Africa and South Asia/Middle East (11.6% versus 50%, 43.4%, 29.3% and 27.3%, respectively, multivariant < 0.05). The microsurgeons with microsurgical fellowships preferred to use free flaps (32.9% versus 17.5%, multivariant = 0.021). There was no difference for the seniority and specialty of the microsurgeons.
The online questionnaire is valuable and feasible for obtaining experts' opinions. This study provides a current global overview of surgical preferences for this common complicated clinical scenario.
上唇缺损的最佳重建策略仍存在争议。本研究的目的是分析通过电子邮件和社交媒体网络分发的在线问卷参与的国际显微外科医生所做的决策。
通过在线问卷展示了一例三分之二上唇肿瘤缺损病例，402名显微外科医生回复了他们的治疗方案。然后根据地理区域、显微外科 fellowship、资历和亚专业对数据进行分析。所有数据均使用SPSS 22进行分析。
共有27.7%的显微外科医生选择游离皮瓣，而72.3%的医生选择局部/带蒂皮瓣作为他们首选的重建方法。游离皮瓣和局部/带蒂皮瓣最常见的选择分别是桡侧前臂皮瓣（73.6%）和阿贝皮瓣（36.2%）。与中/南美洲、亚太地区、非洲和南亚/中东地区相比（分别为11.6%对50%、43.4%、29.3%和27.3%，多变量<0.05），欧洲的显微外科医生更倾向于选择局部/带蒂皮瓣而非游离皮瓣。有显微外科 fellowship 的显微外科医生更倾向于使用游离皮瓣（32.9%对17.5%，多变量=0.021）。显微外科医生的资历和专业没有差异。
在线问卷对于获取专家意见是有价值且可行的。本研究提供了当前全球对于这种常见复杂临床情况的手术偏好概述。
