80岁及以上头颈癌患者游离皮瓣重建的结果。

Results of free flap reconstruction for patients aged 80 years or older with head and neck cancer.

作者信息

Otsuki Naoki, Furukawa Tatsuya, Avinçsal Mehmet Ozgur, Teshima Masanori, Shinomiya Hirotaka, Oshikiri Taro, Nakamura Tetsu, Nomura Tadashi, Hashikawa Kazunobu, Nibu Ken-Ichi

机构信息

Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

Auris Nasus Larynx. 2020 Feb;47(1):123-127. doi: 10.1016/j.anl.2019.04.005. Epub 2019 May 3.

DOI:10.1016/j.anl.2019.04.005

PMID:31060883

Abstract

OBJECTIVE

Free flap reconstruction in elderly patients is one of the most challenging surgeries in the treatment of head and neck cancers. The aim of this study was to examine the oncological and functional outcomes of free flap reconstruction for elderly patients with head and neck cancer.

METHODS

We retrospectively reviewed elderly patients who underwent free flap reconstruction for the treatment of head and neck cancers. All patients were 80 years or older. Clinicopathologic features, surgical procedures, oncological and functional outcomes were obtained from medical records.

RESULTS

Free flap reconstructions were performed in 13 patients (3 female, 10 male). The mean age was 82.6 ± 3.4 years (range: 80-91). The mean follow-up period was 23.3 months (range 4-41 months). The mean disease-free survival was 49 ± 6 months (range 4-60 months). All patients had been alive more than one year after surgery. Reconstruction was performed using free jejunum in 10 patients and radial forearm flap in 3 patients. Graft necrosis occurred in 2 patients. Other two patients experienced major postoperative medical complications.

CONCLUSION

Free flap reconstruction in well-selected older adults is safe and effective. Advanced age should not preclude consideration of free flap reconstruction in those patients.

摘要

目的

游离皮瓣重建术对于老年头颈癌患者而言是最具挑战性的手术之一。本研究旨在探讨老年头颈癌患者游离皮瓣重建术的肿瘤学及功能预后。

方法

我们回顾性分析了接受游离皮瓣重建术治疗头颈癌的老年患者。所有患者年龄均在80岁及以上。从病历中获取临床病理特征、手术过程、肿瘤学及功能预后等信息。

结果

13例患者（3例女性，10例男性）接受了游离皮瓣重建术。平均年龄为82.6±3.4岁（范围：80 - 91岁）。平均随访期为23.3个月（范围4 - 41个月）。平均无病生存期为49±6个月（范围4 - 60个月）。所有患者术后存活超过一年。10例患者采用游离空肠进行重建，3例患者采用桡侧前臂皮瓣。2例患者发生移植皮瓣坏死。另外2例患者术后出现严重医疗并发症。