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[游离旋股深动脉带蒂嵌合肌皮穿支皮瓣多种形式在舌癌切除术后缺损修复中的临床应用]

[Clinical application of various forms of free profunda femoral artery pedicled chimeric myocutaneous perforator flap in defect reconstruction after tongue carcinoma resection].

作者信息

Song Dajiang, Li Zan, Zhou Xiao, Xie Songlin, Wu Jiao, Liu Zhizhong, Peng Wen, Ou Yan, Li Xiaohui, Liu Zeyang

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 Hunan, 410008, P.R.China.

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

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Jun 15;31(6):696-701. doi: 10.7507/1002-1892.201701045.

Abstract

OBJECTIVE

To investigate the clinical anatomy and application of free profunda femoral artery pedicled chimeric myocutaneous perforator flap in the defect reconstruction after radical resection of tongue carcinoma.

METHODS

Between April 2011 and January 2016, 44 cases of tongue carcinoma underwent radical resection, and tongue defects were reconstructed by free profunda femoral artery pedicled chimeric myocutaneous perforator flaps at the same stage. There were 40 males and 4 females, with a mean age of 46.3 years (range, 32-71 years). The pathologic type was squamous cell carcinoma, which involved the lingual margin in 24 cases, the ventral tongue in 17 cases, and the mouth floor in 3 cases. According to Union for International Cancer Control (UICC) TNM staging, 16 cases were rated as T N M , 11 cases as T N M , 9 cases as T N M , and 8 cases as T N M . The course of disease ranged from 1 to 22 months (mean, 8.6 months). The size of perforator flap ranged from 8.5 cm×4.0 cm to 12.0 cm×6.5 cm, and the size of muscle flap ranged from 4.0 cm×3.0 cm to 7.5 cm×5.0 cm. The adductor magnus myocutaneous flap with a pedicle of (8.3±0.5) cm was used in 11 cases, and the gracilis muscle myocutaneous flap with a pedicle of (8.1±0.8) cm was used in 33 cases. The donor sites were sutured directly.

RESULTS

All 44 perforator flaps survived uneventfully, and the donor site healed well. The patients were followed up for 12 to 40 months (mean, 23.8 months). The reconstructed tongue had good appearance and function in swallowing and language. No local recurrence was found. Only linear scar was left at the donor sites.

CONCLUSION

The free profunda femoral artery pedicled chimeric myocutaneous perforator flap can be harvested in various forms, and is an ideal choice to reconstruct defect after radical resection of tongue carcinoma.

摘要

目的

探讨游离股深动脉穿支嵌合肌皮瓣在舌癌根治术后缺损修复中的临床解剖及应用。

方法

2011年4月至2016年1月,44例舌癌患者行根治性切除,同期采用游离股深动脉穿支嵌合肌皮瓣修复舌缺损。男40例,女4例,平均年龄46.3岁(范围32 - 71岁)。病理类型为鳞状细胞癌,其中舌缘癌24例,舌腹癌17例,口底癌3例。根据国际抗癌联盟(UICC)TNM分期,Ⅰ期16例,Ⅱ期11例,Ⅲ期9例,Ⅳ期8例。病程1~22个月(平均8.6个月)。穿支皮瓣大小为8.5 cm×4.0 cm至12.0 cm×6.5 cm,肌瓣大小为4.0 cm×3.0 cm至7.5 cm×5.0 cm。11例采用带蒂长(8.3±0.5)cm的大收肌肌皮瓣,33例采用带蒂长(8.1±0.8)cm的股薄肌肌皮瓣。供区直接缝合。

结果

44例穿支皮瓣全部顺利成活,供区愈合良好。患者随访12~40个月(平均23.8个月)。重建舌外形及吞咽、语言功能良好。无局部复发。供区仅留线性瘢痕。

结论

游离股深动脉穿支嵌合肌皮瓣可形成多种形式,是舌癌根治术后缺损修复的理想选择。

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