前臂皮瓣与股前外侧皮瓣修复舌癌术后缺损的供区主观满意度比较

Comparison of the subjective satisfaction of free radial forearm flap and anterolateral thigh flap for the donor site after surgical reconstruction in tongue cancer patients

目的比较游离前臂皮瓣(FRFF)及股前外侧皮瓣(ALTF)用于舌癌术后缺损重建的供区主观满意度。方法选取2011年8月—2014年10月间在天津市口腔医院和北京大学口腔医院接受FRFF或ALTF重建的121例原发性舌鳞状细胞癌患者为调查对象。2016年10月—2017年1月间采用自制供区病态特异性问卷评估患者主观满意度(包括供区感觉、运动障碍、外观、社交活动及生存质量的总体影响5个方面)。结果 121例中有34例因肿瘤或其他疾病死亡,2例因皮瓣重建术后复发而被剔除,11例失联,最终74例患者完成问卷,FRFF组39例,ALTF组35例。调查结果显示,ALTF组在供区感觉、外观、对总体生存质量的影响及量表总分均高于FRFF组(P<0.05)。2组在运动障碍及社交活动两方面的得分相似(P>0.05)。结论 ALTF具有更好的供区病态,对患者总体生存质量的不良影响较小,满意度较高。

Objective To compare the subjective satisfaction of the free radial forearm flap(FRFF) and anterolateralthigh flap(ALTF) of the donor site after surgical reconstruction for tongue cancer.MethodsA total of 121 consecutivepatients underwent FRFF or ALTF reconstruction after ablative surgery for untreated, primary tongue squamous cellcarcinoma at Tianjin Stomatological Hospital and Peking University School and Hospital of Stomatology from August 2011 toOctober 2014 were enrolled in this study. The subjective satisfaction of the donor site, including sensibility, movementdisabilities, cosmetics, social activities and general impacts on the quality of life(QOL), was assessed by a self-establisheddonor site morbidity questionnaire from October 2016 to January 2017.ResultsOf the 121 patients, 34 died because ofcancer or other diseases, 2 were excluded because of recurrence after reconstruction surgery, 11 lost to contact, and 74(61.2%) completed the questionnaires finally, which included 39 patients in FRFF group and 35 patients in ALTF group. Thescores for sensibility, cosmetics, general impacts on the QOL and composite score were significantly higher in ALTF groupthan those of FRFF group(P < 0.05). No significant differences were found in the movement disabilities and social activitiesbetween the two groups(P > 0.05).ConclusionALTF has the advantage of better results of donor site morbidity, lessadverse effect on the general QOL, and higher subjective satisfaction.