股前外侧肌皮瓣修复颊癌术后缺损23例临床分析

Anterolateral thigh flap for reconstruction of defects after en bloc resection of buccal cancer:a retrospective study of 23 cases

目的 :探讨股前外侧肌皮瓣修复颊癌术后软组织缺损的效果。方法 :2013年5月—2015年5月以股前外侧肌皮瓣修复颊癌术后缺损患者23例。设计并制备股前外侧肌皮瓣单岛或者多岛,修复颊癌术后组织缺损。术后观察口腔颌面部及供区形态和功能,总结皮瓣制取及修复经验。结果:23例股前外侧皮瓣全部成活,其中3例术后24 h内出现血管危象,经抢救后皮瓣成活,成活率100%。随访1~3 a,口腔颌面部及供区形态、功能恢复良好,1例出现颊部积液并感染,经冲洗引流处理后恢复良好;2例术后复发、死亡。结论:股前外侧肌皮瓣修复颊癌术后软组织缺损效果良好,值得临床推广应用。

PURPOSE： This study was aimed to observe the effects of anterolateral thigh flap for reconstruction of tissue defects after en bloc resection of buccal cancer. METHODS： Twenty-three patients with soft tissue defects after en bloc resection of buccal cancer underwent simultaneous reconstruction with anterolateral thigh flap from May, 2013 to May,2015 were observed. Anterolateral thigh flaps were designed and harvested in form of single or multiple islands to restore the defect in buccal region after surgery. The appearance and function of both the oral and maxillofacial region and the donor site were recorded and evaluated. RESULTS： All the 23 flaps survived. Only 3 of them experienced vascular crisis within 24 hours after surgery, and recovered gradually after salvage. The success rate was 100%. One to three years of follow-up showed satisfying morphology and function for both the receipt sites and the donor sites. Buccal abscess was observed in 1 patient and recovered after rinsing and drainage. Two patients died of recurrence. CONCLUSIONS： Good effects can be achieved using anterolateral thigh flap to reconstruct buccal defects after en bloc resection of cancer, which is suitable for application in clinical practice.