改良胸大肌岛状肌皮瓣在舌癌连续整块切除术后缺损修复中的应用

Modified pectoralis major myocutaneous flap for reconstruction of operative defects following en block resection of tongue cancer

目的探讨改良后的胸大肌岛状肌皮瓣修复舌癌连续整块切除术后缺损的效果。方法 2005年1月—2010年6月,对23例舌癌患者采用改良后的胸大肌岛状肌皮瓣修复舌癌连续整块切除术后缺损;观察术后皮瓣成活情况及伤口愈合情况,并随访评价再造舌形态、功能,皮瓣供区功能及皮瓣对术后放疗的耐受性。结果 23例病例肌皮瓣全部存活;再造舌外形满意,全部病例半年内吞咽、语言功能基本恢复;供区瘢痕减少,无功能障碍,放疗患者未出现皮瓣坏死。结论改良的胸大肌岛状肌皮瓣,安全可靠,修复效果好,是修复舌癌连续整块切除后缺损的理想皮瓣。

Objective To evaluate the results of the reconstruction of the operative defects following the en block resection of tongue cancer using modified pectoralis major myocutaneous flap.Methods From January,2005 to June,2010,23 cases who had the operative defects following the en block resection of tongue cancer underwent the reconstruction using modified pectoralis major myocutaneous flap.The vitality of the flaps and the healing of the wounds were observed postoperatively.The shape and function of the reconstructed tongue were determined,the influences on function at donor site were evaluated and the flap tolerance to radiotherapy was investigated during the follow-up period.Results All of the myocutaneous flaps survived in 23 cases.The shape of the reconstructed tongue was satisfactory.The speech as well as swallowing function recovered well in 0.5 year.The scar reduced with no important functional impairment at the donor site.No flap necrosis occurred in all the patients who received postoperative radiotherapy.Conclusions Modified pectoralis major myocutaneous flap is safe and reliable,and it achieves better result at the recipient site,so it is an ideal flap to repair operative defects following the en block resection of tongue cancer.