Department of Dermatology, Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Dermatology, Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Dermatol. 2024 Jun;51(6):799-806. doi: 10.1111/1346-8138.17181. Epub 2024 Mar 5.
Reconstruction of lips after squamous cell carcinoma (SCC) removal should restore functional and aesthetic roles; however, it remains a challenge. In this study we describe the clinical features of lip SCC and suggest a reconstruction algorithm. We retrospectively analyzed 34 patients with lip SCC who underwent reconstruction after Mohs micrographic surgery between January 2006 and March 2022. The mean age of the patients was 70.2 years. Seven tumors were on the upper lip and 27 tumors were on the lower lip. Twenty-five defects were located on the mucosal lip, eight defects involved both the mucosal and cutaneous lips, and one defect was confined to the cutaneous lip. Eighteen defects were smaller than 50% of the total lip size, and 16 were larger than 50%. Primary closure was mostly performed for defects smaller than 50% of the lip size (9/18 cases), and local flap, according to the location and size of the defects, was performed for larger defects. Thirteen patients experienced postoperative complications but improved within 1 year after surgery, except for one patient. We suggest a reconstruction algorithm with a 50% cut-off value. Defects smaller than 50% of the lip size could be reconstructed by primary closure. Even larger defects could be reconstructed by creation of a local flap from the remaining adjacent tissue with minimal postoperative complications.
鳞状细胞癌（SCC）切除后嘴唇的重建应恢复其功能和美学作用，但这仍然是一个挑战。在本研究中，我们描述了嘴唇 SCC 的临床特征，并提出了一种重建算法。我们回顾性分析了 2006 年 1 月至 2022 年 3 月间接受 Mohs 显微外科手术后进行重建的 34 例嘴唇 SCC 患者。患者的平均年龄为 70.2 岁。7 个肿瘤位于上唇，27 个肿瘤位于下唇。25 个缺损位于粘膜唇，8 个缺损涉及粘膜和皮肤唇，1 个缺损局限于皮肤唇。18 个缺损小于唇总大小的 50%，16 个缺损大于 50%。对于小于唇总大小 50%的缺损主要进行直接缝合（9/18 例），对于较大的缺损则根据缺损的位置和大小进行局部皮瓣。13 例患者发生术后并发症，但在术后 1 年内均得到改善，除 1 例患者外。我们建议采用 50%的截断值的重建算法。唇总大小小于 50%的缺损可通过直接缝合来重建。即使更大的缺损也可以通过从剩余相邻组织创建局部皮瓣来重建，术后并发症最小。
