股前外侧皮瓣在颊癌术后缺损重建中的应用

Application of Anterolateral Thigh Flap in Reconstruction of Postoperative Defects of Buccal Cance

目的:探讨游离股前外侧皮瓣在颊癌术后缺损修复重建中的应用。方法:对笔者科室2012年6月-2018年12月应用股前外侧皮瓣修复重建的63例颊癌术后软组织缺损患者的临床资料进行回顾性分析,其中前颊18例,后颊34例,全颊11例,评估移植的成功率及修复效果。结果:63例患者病理类型均为鳞状细胞癌,切取皮瓣面积为4cm×8cm^8cm×20cm。术后59例股前外侧皮瓣顺利成活,发生血管危象4例,经紧急手术探查抢救后,存活3例,坏死1例,成活率为98.4%。术后随访10~72个月,颊部皮瓣形态良好,4例患者出现颊瘘。术后6个月所有患者张口度、言语及咀嚼吞咽功能满意。结论:股前外侧皮瓣组织量丰富,质地柔软,可塑性强,可根据不同颊缺损范围设计一蒂双岛或一蒂多岛,可取皮瓣面积大,手术可操作性强,术后供区损伤小,是修复颊癌根治术后缺损的理想皮瓣。

Objective To explore the application of free anterolateral femoral flap in the reconstruction postoperative defects of buccal cancer.Methods From June 2012 to December 2018,63 cases of buccal cancer with soft tissue defect repaired by anterolateral femoral flap were analyzed retrospectively.Among them,18 cases were anterior buccal,34 cases were posterior buccal and 11 cases were total buccal.To evaluate the success rate and repair effect of transplantation.Results The pathological types of 63 patients were squamous cell carcinoma.The flap area was 4cm×8 cm-8cm×20cm.After operation,59 cases of anterolateral thigh flap survived successfully and 4 cases developed vascular crisis.After emergency operation,3 cases survived,1 case necrotic,the survival rate was 98.4%.After 10-72 months follow-up,the buccal flap was in good shape,and 4 patients had buccal fistula.At 6 months after the operation,all the patients had satisfactory mouth opening,speech,chewing and swallowing functions.Conclusion The anterolateral thigh flap has abundant tissue,soft texture,strong plasticity,and the small injury of donor area.It is an ideal flap for repairing the defect after radical operation of buccal cancer.