Zang Jian, Feng Shuai, Yang Huijun, Guo Xing
Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
Medicine (Baltimore). 2020 Feb;99(9):e19361. doi: 10.1097/MD.0000000000019361.
Successful reconstruction after tumor resection facilitates rapid recovery and retention of good quality of life, and this is important for a successful operation. This study aimed to analyze and compare the application and efficacy of xenogeneic acellular dermal matrix (xeno-ADM) and abdominal skin graft in hypopharynx reconstruction.This is a retrospective cohort study that included 25 patients with posterior hypopharyngeal wall cancer who underwent partial hypopharyngectomy with laryngeal preservation. The patients were divided into 2 groups according to the repair materials used. Eleven patients were treated with xeno-ADM, and 14 patients with abdominal skin grafts for repairing hypopharyngeal mucosal defects. The intraoperative data, postoperative recovery time of eating function, graft contraction, infection and pharyngeal fistula rate, and 1-year survival rate of the 2 groups were analyzed and compared.Compared with skin grafts group (23.1 ± 5.8 days), the recovery time of eating function in xeno-ADM group was shorter (17.3 ± 6.4 days), (P = .026). Also the number of postoperative hospitalization days were less in the xeno-ADM group (18.5 ± 6.7 days) than in the skin grafts group (24.1 ± 5.6 days) (P = .035). Besides, no significant differences were observed in other comparisons between the 2 groups. Also no obvious rejection and severe graft contraction were observed in both the groups. All patients were successfully decannulated.Both xeno-ADM and abdominal skin grafts demonstrated good effects in the reconstruction of hypopharynx, but the recovery time of eating function in patients with xeno-ADM was faster, which may be due to rapid epithelialization. In addition, it avoids trauma of donor sites.
肿瘤切除术后的成功重建有助于快速康复并保持良好的生活质量,这对手术成功至关重要。本研究旨在分析和比较异种脱细胞真皮基质(xeno-ADM)和腹部皮肤移植在下咽重建中的应用及疗效。
这是一项回顾性队列研究,纳入了25例接受保留喉功能的部分下咽切除术的下咽后壁癌患者。根据使用的修复材料将患者分为2组。11例患者采用xeno-ADM治疗,14例患者采用腹部皮肤移植修复下咽黏膜缺损。分析比较两组的术中数据、术后进食功能恢复时间、移植皮片收缩、感染及咽瘘发生率以及1年生存率。
与皮肤移植组(23.1±5.8天)相比,xeno-ADM组进食功能恢复时间更短(17.3±6.4天),(P = 0.026)。xeno-ADM组术后住院天数(18.5±6.7天)也少于皮肤移植组(24.1±5.6天)(P = 0.035)。此外,两组在其他比较中未观察到显著差异。两组均未观察到明显的排斥反应和严重的移植皮片收缩。所有患者均成功拔管。
xeno-ADM和腹部皮肤移植在下咽重建中均显示出良好效果,但xeno-ADM组患者进食功能恢复更快,这可能是由于上皮化迅速。此外,它避免了供区创伤。