带血管蒂肌皮瓣在头颈部根治性放疗后复发癌切除中的应用

Application of the muscular flaps with vessel for repair defect in patients of head and neck recurrence cancer after radical radiotherapy

目的:探讨带血管蒂肌皮瓣在头颈部根治放疗后复发癌手术中的应用。方法:对６６例头颈部根治放疗后复发癌病人施行手术,其中６０例应用了带血管蒂肌皮瓣,应用皮瓣有胸大肌肌皮瓣、斜方肌肌皮瓣、背阔肌肌皮瓣、胸三角肌皮瓣及额部皮瓣。结果:６０例病人的３年生存率和５年生存率分别为６８．３%和５１．７%。有４例喉癌术后病人合并巨大咽瘘,其余生存质量均得到了改善。结论:根治性放疗后复发癌病人,局部血液循环差,头颈部重要生命血管表浅,应用带血管蒂肌皮瓣的目的不仅仅是为了修复局部缺损,更重要的是改善局部血液循环,以利于创口愈合,提高病人生存质量。

ve: To explore the effect of muscular flaps with vessel in head and neck recurrence cancer after radical radiotherapy. Methods: There were 66 cases with head and neck recurrence carcinoma after radical radiotherapy (54 males and 12 females,ranging in age from 32 to 68 years old). Among 66 cases, 60 were repaired with muscular flaps in the defect areas. There were pectoralic major flaps,trapezius muscle flaps,latissimus dorsi flaps,pectoralic-deltoid flaps and frontal flaps respectively. Results: The 3-year survival rate and 5-year survival rate of the 60 patients were 68.3%(38/60)and 51. 7% (31/60)respectively. The complications were 4 patients with large pharynx fistulas, the living conditions of other cases were improved. Conclusions: The muscular flaps with vessel were useful materials in the reconstruction of partial defects on the patients of head and neck recurrence carcinoma after radical radiotherapy. The clinical application of this technique should be beneficial for improve live quality of patients.