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头颈癌中带蒂皮瓣与游离皮瓣重建术:来自单一手术团队的临床结果分析

Pedicled Flap vs. Free Flap Reconstruction in Head and Neck Cancers: Clinical Outcome Analysis from a Single Surgical Team.

作者信息

Katna Rakesh, Girkar Farhana, Tarafdar Debayan, Bhosale Bharat, Singh Shambhavi, Agarwal Suyash, Deshpande Akshay, Kalyani Nikhil

机构信息

Department of Oncology, Jaslok Hospital and Research Centre, Pedder Road, Mumbai, 400026 India.

Bombay Hospital and Research Centre, Marine Lines, Mumbai, India.

出版信息

Indian J Surg Oncol. 2021 Sep;12(3):472-476. doi: 10.1007/s13193-021-01353-1. Epub 2021 May 17.

Abstract

Head and neck cancers are one of the leading causes of morbidity and mortality in Indian population. Reconstruction and restoration of function are also of paramount importance in these patients. The aim of this study was to report outcomes for free flaps and pedicle flaps in patients with oral cavity cancers. A retrospective analysis of 628 patients with oral cavity cancers who underwent reconstruction with either free flaps or pedicle flaps during 2014-2020 was done. The median age of the cohort was 49 years. The free flap reconstruction was performed in 481 (76%) and pedicle flap in 147 (24%) patients. Among free and pedicle flaps, 27 (5.6%) and 3 (2.1%) respectively had major flap complications and 25 (5.1%) and 14 (9.9%) respectively had minor complications. CCI score > 4 was associated with higher events ( = 0.02) in free flap group. The outcomes of free flaps are similar in comparison to pedicle flaps in patients with oral cavity cancers. The higher CCI score is significantly associated with increased flap-related complications for the free flap group.

摘要

头颈癌是印度人口发病和死亡的主要原因之一。对这些患者而言,功能的重建和恢复也至关重要。本研究的目的是报告口腔癌患者游离皮瓣和带蒂皮瓣的治疗结果。对2014年至2020年间接受游离皮瓣或带蒂皮瓣重建的628例口腔癌患者进行了回顾性分析。该队列的中位年龄为49岁。481例(76%)患者接受了游离皮瓣重建,147例(24%)患者接受了带蒂皮瓣重建。在游离皮瓣和带蒂皮瓣中,分别有27例(5.6%)和3例(2.1%)发生了严重皮瓣并发症,25例(5.1%)和14例(9.9%)分别发生了轻微并发症。在游离皮瓣组中,CCI评分>4与更高的事件发生率相关(P = 0.02)。在口腔癌患者中,游离皮瓣的治疗结果与带蒂皮瓣相似。较高的CCI评分与游离皮瓣组皮瓣相关并发症的增加显著相关。

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