Villarmé A, Pace-Loscos Tanguy, Schiappa Renaud, Poissonnet Gilles, Dassonville Olivier, Chamorey Emmanuel, Bozec Alexandre, Culié Dorian
Institut Universitaire de la Face et du Cou, Head and neck department, 31 avenue de Valombrose, Nice, France.
Epidemiology and Biostatistic Unit, Centre Antoine Lacassagne, Nice, France.
Eur J Surg Oncol. 2024 Mar;50(3):108008. doi: 10.1016/j.ejso.2024.108008. Epub 2024 Feb 9.
Mandible reconstruction using a free fibula flap (FFF) is preferably performed with virtual surgical planning (VSP) to potentially improve functional and aesthetic outcomes. However, VSP is time-consuming. This study aims to assess the impact of VSP on time to surgery (TS).
All patients who underwent FFF for oral cavity cancer between 2007 and 2020 were included. Time to surgery (from the date of the first consultation to the surgery date) was compared between patients without VSP and with VSP. In our department, VSP and 3D modeling were performed by an external engineering laboratory.
One hundred sixty-five patients were included retrospectively. VSP was utilized for 90 patients (55%). The mean time to surgery was 31 ± 16 days for patients undergoing conventional surgery without VSP and 44 ± 19 days for patients with VSP (p < 0.001). No clinical or tumoral characteristic were associated with a TS extended, except for the utilization of VSP (p < 0.001). By constituting groups of 25 consecutive patients, there is no difference in TS between the groups.
The use of VSP significantly increased the time to surgery in our study, unrelated to clinical differences or year of surgery. This delay may have an impact on oncologic outcomes, so it should be considered in the care organization for each patient. Implementing new procedures to reduce this difference is warranted.
使用游离腓骨瓣（FFF）进行下颌骨重建时，最好采用虚拟手术规划（VSP），以潜在地改善功能和美学效果。然而，VSP耗时较长。本研究旨在评估VSP对手术时间（TS）的影响。
纳入2007年至2020年间所有接受FFF治疗口腔癌的患者。比较未使用VSP和使用VSP的患者的手术时间（从首次会诊日期到手术日期）。在我们科室，VSP和三维建模由外部工程实验室进行。
回顾性纳入165例患者。90例患者（55%）使用了VSP。未使用VSP的传统手术患者的平均手术时间为31±16天，使用VSP的患者为44±19天（p<0.001）。除了使用VSP外，没有临床或肿瘤特征与手术时间延长相关（p<0.001）。按连续25例患者分组，各组之间的手术时间没有差异。
在我们的研究中，使用VSP显著增加了手术时间，这与临床差异或手术年份无关。这种延迟可能会对肿瘤治疗结果产生影响，因此在为每位患者制定护理方案时应予以考虑。有必要实施新的程序来减少这种差异。
