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异种脱细胞真皮基质与皮肤移植修复下咽癌术后缺损的比较:一项回顾性队列研究。

Comparison of xenogeneic acellular dermal matrix and skin grafts in reconstruction of postoperative defects of hypopharyngeal cancer: A retrospective cohort study.

作者信息

Zang Jian, Feng Shuai, Yang Huijun, Guo Xing

机构信息

Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.

出版信息

Medicine (Baltimore). 2020 Feb;99(9):e19361. doi: 10.1097/MD.0000000000019361.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df3b/7478681/9d499f601dc5/medi-99-e19361-g001.jpg

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