Mäkitie A, Aitasalo K, Pukander J, Virtaniemi J, Hyrynkangas K, Suominen E, Vuola J, Kontio R, Markkanen-Leppänen M, Lehtonen H, Asko-Seljavaara S, Grénman R
Department of Otolaryngology, Helsinki University Hospital, Finland.
Acta Otolaryngol Suppl. 1997;529:245-6. doi: 10.3109/00016489709124134.
Microvascular free tissue transfer has in many cases replaced classic flap techniques and is now an established workhorse for head and neck reconstructions. In this retrospective study the over 300 patients, who had microvascular free flap reconstructions in head and neck cancer surgery in Finland during a 10-year period (1986-1995) were reviewed. The operations were performed in the University Hospitals by plastic surgeons, ENT specialists or maxillofacial surgeons. The cases consisted of defects resulting from resection of oral cavity tumors (63%), mid- or upper-face and skullbase tumors (20%) and hypopharyngo-esophageal tumors (17%). The series includes a wide range of flap types and analyses flap outcome and complications. A total of 313 cases was reconstructed by 317 flaps (forearm flaps 47%, latissimus dorsi flaps 19%, free jejunum or colon transfers 15%, free iliaca crest flaps 8% and other flaps 11%). Thrombosis of one of the vessels and haematoma were the most frequent causes of failure in microvascular free tissue transfer. A total flap necrosis occurred in 27 (8.5%) and a partial necrosis in 12 (4%) patients. The most reliable flap in terms of survival was the radial forearm flap. The ever-improving success of microvascular free tissue transfer has made it a useful procedure for head and neck reconstructions. There is also a growing need for microvascular team surgery in the field of head and neck cancer therapy.
微血管游离组织移植在许多情况下已取代了传统的皮瓣技术，如今已成为头颈部重建的常用方法。在这项回顾性研究中，对芬兰10年间（1986 - 1995年）在头颈部癌手术中接受微血管游离皮瓣重建的300多名患者进行了回顾。手术由大学医院的整形外科医生、耳鼻喉科专家或颌面外科医生进行。病例包括口腔肿瘤切除所致缺损（63%）、面中上部和颅底肿瘤（20%）以及下咽 - 食管肿瘤（17%）。该系列包括多种皮瓣类型，并分析了皮瓣的结果和并发症。总共313例患者用317块皮瓣进行了重建（前臂皮瓣47%，背阔肌皮瓣19%，游离空肠或结肠移植15%，游离髂嵴皮瓣8%，其他皮瓣11%）。血管血栓形成和血肿是微血管游离组织移植失败的最常见原因。27例（8.5%）患者出现皮瓣完全坏死，12例（4%）患者出现部分坏死。就存活率而言，最可靠的皮瓣是桡侧前臂皮瓣。微血管游离组织移植不断提高的成功率使其成为头颈部重建的一种有用方法。在头颈部癌症治疗领域，对微血管团队手术的需求也在不断增加。
