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头颈部手术中的微血管游离皮瓣重建:80例皮瓣的并发症及结果

Microvasular Free Flap Reconstruction in Head and Neck Surgery: Complication and Outcome of 80 Flaps.

作者信息

Gill Gur Paramjeet Singh, Chitale Priyadarshan, Bakshi Rupinder, Yadav Amit, Gill Vikram Jeet Singh

机构信息

NC Medical College, Israna, Panipat, India.

Shri Sidhivinayak Ganpati Cancer Hospital, Miraj, Sangli, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6246-6250. doi: 10.1007/s12070-021-02958-2. Epub 2021 Nov 23.

Abstract

Head and neck carcinoma can prompt destroying cosmetic and functional deformities with resultant mental, physical and nourishing burden. Regardless of ongoing advances in medication and surgical procedure, the general endurance for patients with head and neck malignant growth has stayed still for as long as 35 years. This endurance rate has prompted the foundation of the standards of tumor extraction with most extreme tissue saving and more up to date endoscopic laser-helped methods for auto-digestive region malignant growths targeting diminishing operational morbidity without influencing the general endurance. This retrospective and prospective study contained 80 patients who went through miniature vascular free flap remaking following a significant head and neck oncosurgery procedure from 01/01/2017-to-31/12/2019. Three kinds of free flaps were fundamentally utilized. The current study was directed to assess the clinical result in patients going through miniature vascular free flap reproduction and to decide the viability after head and neck onco-surgical procedure method. Despite the fact that miniature vascular free flaps are today viewed as cutting edge in head and neck remaking after composite resection with predominant effective and stylish rebuilding, it is as yet not basic in India at numerous focuses. This retrospective and prospective study were conducted for a time of 3 years to know the clinical result, decide the adequacy and assess the occurrence and reasons for pre- and post-surgical intricacies in patients going through miniature vascular free flap recreation after head and neck onco-surgical procedure method. It was inferred that the free flaps were dependable in accomplishing effective reproduction of the head and neck following an effective onco-surgical procedure methodology. Despite the fact that there is a critical loss of delicate tissue and bone however after an effective acknowledgment of free flap, close to ordinary anatomical and physiological capacities can be accomplished in larger part of the patients. The frequency of complexities was straightforwardly related to the co-morbidity level and specialist's working experience.

摘要

头颈癌可导致毁容和功能畸形,从而造成心理、身体和营养负担。尽管药物和外科手术不断进步,但头颈癌患者的总体生存率在长达35年的时间里一直停滞不前。这种生存率促使人们建立了肿瘤切除标准,即最大限度地保留组织,并采用更新的内镜激光辅助方法治疗消化道肿瘤,目标是降低手术发病率而不影响总体生存率。这项回顾性和前瞻性研究纳入了80例患者,他们在2017年1月1日至2019年12月31日接受重大头颈肿瘤外科手术后进行了微血管游离皮瓣重建。主要使用了三种游离皮瓣。本研究旨在评估接受微血管游离皮瓣重建患者的临床结果,并确定头颈肿瘤外科手术后的有效性。尽管如今微血管游离皮瓣在复合切除术后的头颈重建中被视为先进技术,具有卓越的功能和美观重建效果,但在印度的许多地方它仍不普及。这项回顾性和前瞻性研究进行了3年,以了解临床结果,确定有效性,并评估接受头颈肿瘤外科手术后进行微血管游离皮瓣重建患者术前和术后并发症的发生率及原因。研究得出结论,游离皮瓣在有效的肿瘤外科手术方法后对头颈进行有效重建方面是可靠的。尽管软组织和骨有明显缺失,但在游离皮瓣成功植入后,大部分患者能够实现接近正常的解剖和生理功能。并发症的发生率与共病水平和医生的工作经验直接相关。

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