Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy.
Acta Otorhinolaryngol Ital. 2021 Dec;41(6):523-529. doi: 10.14639/0392-100X-N1152. Epub 2021 Nov 26.
To describe the surgical technique of the supraclavicular artery fascial flap (SAFF) and outcomes in neopharyngeal covering with overlay technique during salvage total laryngectomy for residual or recurrent carcinoma after chemo/radiation treatment.
Chart review of patients treated between October 2018 and February 2019 at two tertiary care hospitals. Variables extracted from patient records were age, gender, history of chemo/radiation therapy, neck dissection, surgical and postoperative complications. Outcomes measured were surgical time, postoperative complications and flap failure, oral intake start and patient discharge.
Ten male patients were included. Median age was 64 years. All patients underwent salvage total laryngectomy and neopharyngeal covering with SAFF. Mean flap harvest time was 25 minutes. No surgical complications or flap failure were recorded. Oral intake was started on a median of post-operative day 10. No cases of pharyngocutaneous fistula were encountered.
SAFF is a reliable, easy and quick to harvest flap, which provides a good alternative to other pedicled and free flaps for hypopharyngeal coverage in laryngeal salvage surgery. Donor site morbidity is almost null and postoperative complications are very rare.
描述锁骨下动脉筋膜瓣（SAFF）的手术技术，并介绍在接受放化疗后残余或复发的头颈部癌患者行挽救性全喉切除术后，采用覆盖技术用 overlay 技术覆盖新咽部的结果。
对 2018 年 10 月至 2019 年 2 月期间在两家三级护理医院接受治疗的患者进行图表回顾。从患者记录中提取的变量包括年龄、性别、放化疗史、颈部清扫术、手术和术后并发症。测量的结果包括手术时间、术后并发症和皮瓣失败、开始口服摄入和患者出院。
共纳入 10 例男性患者。中位年龄为 64 岁。所有患者均接受挽救性全喉切除术和 SAFF 覆盖新咽部。平均皮瓣采集时间为 25 分钟。未记录到手术并发症或皮瓣失败。中位术后第 10 天开始口服摄入。未发生咽皮瘘。
SAFF 是一种可靠、简便、快速的皮瓣采集方法，为挽救性喉切除术下咽覆盖提供了一种很好的替代其他带蒂和游离皮瓣的方法。供区并发症发生率低，术后并发症罕见。
