Mahajan Arjun, Kumar Janani Anand, Singh Akhilesh Kumar, Sharma Naresh Kumar, Durrani Farhan, Agrawal Neeraj Kant, Jf Neville
Fellow Head and Neck Oncology, Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
FHNO Oral Oncology Fellow, Aster Malabar Institute of Medical Sciences, Kozhikode, Kerala India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3390-3395. doi: 10.1007/s12070-024-04697-6. Epub 2024 Apr 12.
Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022. These 2 flaps were compared in terms of parameters like time utilised for reconstruction, hospital stay, overall survival and Washington University Quality of Life index(UW-QOL) for head and neck cancer. Patients were followed regularly for post-operative complications. The University of Washington Quality of Life score (UW-QOL) questionnaire, version 4, was completed at six months post-operatively. Obtained data was statistically analysed using IBM SPSS. Washington University Quality of Life index scores and esthetics are better with Antero-lateral thigh flap, with less overall post-operative complications. On the other hand Pectoralis myocutaneous flap has less surgical time and more salvage potential. Despite of Antero-lateral thigh flap having Good Washington University Quality of Life index scores, lesser post-operative complications and better esthetics; scale of developing nations is still tipping towards economical, less time consuming and less technique sensitive Pectoralis major myocutaneous flap.
本研究是一项对比评估,涉及前外侧大腿(ALT)皮瓣和胸大肌肌皮(PMMC)皮瓣对癌症患者重建时皮瓣选择的经济影响、临床结果以及切除术后生活质量评估。已获得机构伦理委员会的伦理批准。在这项针对49例口腔鳞状细胞癌病例的非随机前瞻性研究设计中,2020年至2022年期间,39例患者使用PMMC皮瓣进行重建,10例患者使用ALT皮瓣进行重建。对这两种皮瓣在重建所用时间、住院时间、总生存率以及头颈部癌症的华盛顿大学生活质量指数(UW-QOL)等参数方面进行了比较。定期对患者进行术后并发症随访。术后六个月完成了华盛顿大学生活质量评分(UW-QOL)问卷第4版。使用IBM SPSS对获得的数据进行统计分析。前外侧大腿皮瓣的华盛顿大学生活质量指数评分和美观度更好,术后总体并发症更少。另一方面,胸大肌肌皮瓣的手术时间更短,挽救潜力更大。尽管前外侧大腿皮瓣具有良好的华盛顿大学生活质量指数评分、较少的术后并发症和更好的美观度,但在发展中国家,天平仍倾向于选择经济、耗时少且技术敏感性低的胸大肌肌皮瓣。