Zhang Jun, Wang Yujing, Han Xiaoxue, Chen Huiqiao
Nurse in Charge, Professor, Department of Oromaxillofacial-Head and Neck Surgery and Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
Nurse in Charge, Professor, Department of Oromaxillofacial-Head and Neck Surgery and Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
J Oral Maxillofac Surg. 2020 Sep;78(9):1639-1644. doi: 10.1016/j.joms.2020.04.045. Epub 2020 May 8.
Our goal was to compare the clinical results and quality-of-life (QoL) in tongue cancer patients undergoing submental island pedicled (SIP) flap and radial forearm free (RFF) flap reconstruction.
Patients undergoing SIP or RFF flap reconstruction for primary tongue squamous cell carcinoma were prospectively enrolled and were asked to complete the University of Washington Quality-of-Life (UW-QOL) questionnaire, version 4, at 12 months after the operation. The study's main interest was QoL as well as locoregional recurrence control.
A total of 190 patients were enrolled for analysis, and the SIP and RFF groups showed significant differences in patient age, American Society of Anesthesiologists classification, and hospital cost. In the survival analysis, locoregional recurrence occurred in 35 patients in the SIP group and 48 patients in the RFF group; the difference was not significant (P = .440). In the QoL analysis, compared with patients in the SIP group, those in the RFF group had higher scores in the domains of activity and recreation. No significant differences were found with respect to the other domains.
The SIP flap and RFF flap have comparable survival control in tongue squamous cell carcinoma patients. The RFF flap might lead to better QoL, but the SIP flap imposes fewer limitations on patients' health status and is associated with lower hospital cost.
我们的目标是比较接受颏下岛状带蒂（SIP）皮瓣和桡侧前臂游离（RFF）皮瓣重建的舌癌患者的临床结果和生活质量（QoL）。
前瞻性纳入因原发性舌鳞状细胞癌接受SIP或RFF皮瓣重建的患者，并要求他们在术后12个月完成华盛顿大学生活质量（UW-QOL）问卷第4版。该研究的主要关注点是生活质量以及局部区域复发控制。
共纳入190例患者进行分析，SIP组和RFF组在患者年龄、美国麻醉医师协会分级和住院费用方面存在显著差异。在生存分析中，SIP组有35例患者发生局部区域复发，RFF组有48例患者发生局部区域复发；差异无统计学意义（P = 0.440）。在生活质量分析中，与SIP组患者相比，RFF组患者在活动和娱乐领域得分更高。在其他领域未发现显著差异。
SIP皮瓣和RFF皮瓣在舌鳞状细胞癌患者中的生存控制效果相当。RFF皮瓣可能会带来更好的生活质量，但SIP皮瓣对患者健康状况的限制较少，且住院费用较低。
