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游离胃瓣用于口腔重建——口腔缺损的可行性研究

Free Gastric Flap for Oral Reconstruction-a Feasibility Study in Oral Defects.

作者信息

Komanduri Suneel Kaushik, Hormuzdi Dinshaw, Desai Sharad Shankar, Patil Dipti Babasaheb, Khivasara Jayesh Shirishkumar, Kulkarni Sanika G S, Desai Shivani Sharad

机构信息

Consultant Oncosurgery Unit, Mahatma Gandhi Cancer Hospital, Miraj, India.

Department of Head And Neck Surgery Unit, Mahatma Gandhi Cancer Hospital, Miraj, India.

出版信息

Indian J Surg Oncol. 2021 Mar;12(1):172-176. doi: 10.1007/s13193-020-01276-3. Epub 2021 Jan 6.

Abstract

BACKGROUND

Free flap transfer is a standard practice in reconstruction of oral defects. Fasciocutaneous flaps are commonly used for reconstruction of soft tissue defects. Replacement of oral mucosa with skin often causes discomfort, foreign body sensation, dysgeusia, problems with skin hair and morbidity at the donor site. Morbidity at the donor site may interfere with physical activity among manual labourers.

MATERIALS AND METHODS

We prospectively analysed nine cases of oral cavity defects reconstructed with free gastro-omental flap over 4 months from March to July 2019. A free gastric flap based on right and left gastric artery and vascular arcade was harvested from the body of stomach. Feasibility, technical aspects, advantages and disadvantages of the flap are reviewed.

RESULTS

Flap survival was 100%. No re-exploration for salvage was required. Flap was monitored for viability by colour change and capillary refill. All the nine cases healed well. One patient required readmission for bleeding from the raw area exposed at the margins of the flap. Patient satisfaction and quality of life was satisfactory. Long pedicle length, rich submucosal vascular network, dual pedicles available for anastomosis, like to like mucosal tissue replacement and low donor site morbidity make it a reliable option in the armamentarium of oral reconstruction.

CONCLUSION

Free gastro-omental flap is a feasible and reliable tissue available for reconstruction of oral soft tissue defects.

摘要

背景

游离皮瓣移植是口腔缺损修复的标准术式。筋膜皮瓣常用于软组织缺损的修复。用皮肤替代口腔黏膜常导致不适、异物感、味觉障碍、皮肤毛发问题以及供区并发症。供区并发症可能会影响体力劳动者的身体活动。

材料与方法

我们前瞻性分析了2019年3月至7月4个月期间采用游离胃网膜瓣修复口腔缺损的9例病例。基于胃左右动脉和血管弓切取带蒂游离胃瓣,供区取自胃体。对该皮瓣的可行性、技术要点、优缺点进行了综述。

结果

皮瓣成活率为100%。无需再次手术挽救。通过颜色变化和毛细血管充盈情况监测皮瓣存活情况。所有9例患者愈合良好。1例患者因皮瓣边缘暴露的创面出血需再次入院治疗。患者满意度和生活质量令人满意。蒂长、黏膜下血管网丰富、有双蒂可供吻合、能实现黏膜组织同类替代以及供区并发症少,使其成为口腔修复手段中的可靠选择。

结论

游离胃网膜瓣是修复口腔软组织缺损的一种可行且可靠的组织。

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本文引用的文献

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Gastro-omental free flap for reconstruction of tongue defects.胃网膜游离皮瓣在舌缺损重建中的应用。
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Vascular anatomy of the stomach related to resection procedures strategy.与胃切除手术策略相关的胃血管解剖学
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