Liu Shuo, Zhang Wen-Bo, Yu Yao, Wang Yang, Mao Chi, Guo Chuan-Bin, Yu Guang-Yan, Peng Xin
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China.
Laryngoscope. 2019 Aug;129(8):1915-1921. doi: 10.1002/lary.27442. Epub 2018 Aug 27.
The objective of this study was to identify the factors that influence free flap survival after head and neck reconstructive surgery in pediatric patients.
One hundred thirty consecutive cases of head and neck reconstruction with free flaps in pediatric patients at the Department of Oral and Maxillofacial Surgery at Peking University School and Hospital of Stomatology, Beijing, People's Republic of China, between 1999 and 2017 were reviewed. A single head and neck surgical team performed all the included surgeries. Demographic and surgical patient data with possible associations with free flap survival were recorded. Relevant influencing factors were determined using the χ test and logistic regression analysis.
There were 135 free flap transfers performed in the patients, with an overall success rate of 95.6%. Free flap failure occurred in six flaps (4.4%). Arterial crisis was the main cause of flap failure. The overall complication rate was 7.0%. Patient age (5-9 years old; odds ratio, 13.397; 95% confidence interval, 1.167-153.838; P = 0.037) was a statistically significant risk factor influencing free flap survival. Donor site, defect region, recipient vessel, and surgery time were not associated with free flap outcome.
Free flap transfer for head and neck reconstruction in pediatric patients is safe and reliable. However, special attention should be paid to pediatric patients under 9 years of age when performing head and neck reconstruction.
4 Laryngoscope, 129:1915-1921, 2019.
本研究的目的是确定影响小儿患者头颈部重建手术后游离皮瓣存活的因素。
回顾了1999年至2017年期间在中国北京北京大学口腔医学院口腔颌面外科连续进行的130例小儿患者头颈部游离皮瓣重建病例。所有纳入手术均由同一个头颈部外科团队完成。记录了可能与游离皮瓣存活相关的人口统计学和手术患者数据。使用χ检验和逻辑回归分析确定相关影响因素。
患者共进行了135次游离皮瓣移植，总体成功率为95.6%。6例皮瓣（4.4%）出现游离皮瓣失败。动脉危象是皮瓣失败的主要原因。总体并发症发生率为7.0%。患者年龄（5 - 9岁；比值比，13.397；95%置信区间，1.167 - 153.838；P = 0.037）是影响游离皮瓣存活的统计学显著危险因素。供区、缺损区域、受区血管和手术时间与游离皮瓣结果无关。
小儿患者头颈部重建的游离皮瓣移植是安全可靠的。然而，在进行头颈部重建时，应特别关注9岁以下的小儿患者。
4 《喉镜》，129:1915 - 1921，2019年。
