全喉切除重建术中股前外侧皮瓣与腓骨皮瓣效果的比较。
Comparison of the outcomes of anterolateral thigh flap and peroneal flap in total laryngectomy reconstruction.
作者信息
Hsieh Yu-Hsuan, Chen I-Wen, Lin Cheng-Ta, Yang Kuo-Chung, Liu Wen-Chung, Chiu Ching-Ching, Lee Shih-Yu, Chen Lee-Wei
机构信息
Division of Plastic and Reconstructive Surgery, Department of Surgery Kaohsiung Veterans General Hospital Kaohsiung City Taiwan.
School of Medicine College of Medicine, National Yang Ming Chiao Tung University Taipei Taiwan.
出版信息
Laryngoscope Investig Otolaryngol. 2023 Apr 20;8(3):645-650. doi: 10.1002/lio2.1062. eCollection 2023 Jun.
BACKGROUND
We usually use an ALT or peroneal flap in total laryngectomy reconstruction, depending on the surgeons' preference. No direct comparison of the outcomes of the ALT flap and peroneal flap exists.
METHODS
From 2014 to 2022, we reviewed patients who had total laryngectomy and were reconstructed with an ALT flap and peroneal flap. Patient characteristics and surgical outcomes were collected and compared.
RESULTS
The peroneal group had a significantly higher risk of neopharynx leakage (40% vs. 13.2%, = .020) and late pharyngocutaneous fistula formation (30% vs. 5.3%, = .009) than the ALT group. Peroneal flap was found to be the only independent risk factor for neopharynx leakage ( = .025, odds ratio [OR] = 5.5) and late pharyngocutaneous fistula formation ( = .02, OR = 7.7) in multivariate logistic regression.
CONCLUSION
In the reconstruction of total laryngectomy, the ALT flap is preferable over the peroneal flap.
背景
在全喉切除术重建中，我们通常根据外科医生的偏好使用股前外侧皮瓣或腓骨皮瓣。目前尚无对股前外侧皮瓣和腓骨皮瓣的结果进行直接比较的研究。
方法
回顾2014年至2022年间接受全喉切除术并采用股前外侧皮瓣和腓骨皮瓣进行重建的患者。收集并比较患者的特征和手术结果。
结果
与股前外侧皮瓣组相比，腓骨皮瓣组咽瘘和晚期咽皮瘘形成的风险显著更高（分别为40% 对13.2%，P = 0.020；30% 对5.3%，P = 0.009）。多因素逻辑回归分析发现，腓骨皮瓣是咽瘘（P = 0.025，比值比[OR]=5.5）和晚期咽皮瘘形成（P = 0.02，OR = 7.7）的唯一独立危险因素。
结论
在全喉切除术重建中，股前外侧皮瓣优于腓骨皮瓣。
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