游离股前外侧皮瓣在老年口腔癌患者术后缺损修复中的应用

The application of free anterolateral thigh flaps in the reconstruction of tissue defects following radical resection of elderly patients with oral cancer

目的:探讨游离股前外侧皮瓣在老年口腔癌患者根治术后组织缺损修复中的应用。方法:2013年3月至2014年12月,采用股前外侧皮瓣游离移植修复32例(男性20例,女性12例,年龄60-76岁,平均年龄68.4岁)口腔癌患者接受根治术后的缺损,其中舌癌18例,牙龈癌3例,颊癌5例,口咽癌3例,口底癌3例,分析总结移植的修复成功率和术后效果。结果:31例移植皮瓣成活,1例坏死,成活率为96.8%,皮瓣术后近期和远期随访效果均满意,供区无明显后遗症。结论:游离股前外侧皮瓣组织量丰富,血运可靠,可切取面积大而且可塑性良好,是修复老年口腔癌患者术后软组织较大缺损的理想游离皮瓣。

Objective： We performed this study to explore the application of free anterolateral thigh flaps in the reconstruction of tissue defects following radical resection of elderly patients with oral cancer. Methods： Thirty-two elderly patients（20 males and 12 females, aged 60 to 76 years, mean age 68.4 years） with oral cancer received anterolateral thigh flap graft surgery to repair the tissue defects, from March 2013 to December 2014. The subjects included 18 tongue carcinomas, 3 gingival carcinomas, 5 buccal carcinomas, 3 oropharyngeal carcinomas and 3 carcinomas of floor of mouth.We analyzed and summarized the transplant success rate of repair and postoperative results. Results： Among the 32 cases,31 flaps survived completely with satisfaction, only 1 patient had necrosis, and thus the survival rate was 96.8%. The prognosis of flap surgery was satisfactory, regardless of the short or long term observation. No apparent sequela was observed. Conclusion： The free anterolateral thigh flap is an ideal choice for reconstruction of tissue defects following radical resection of elderly patients with oral cancer, as it has many advantages such as abundant amount of tissue,reliable blood supply, sufficient size available and good plasticity.