腓肠肌内侧动脉穿支皮瓣解剖及其在修复口咽恶性肿瘤术后缺损中的应用

Anatomy of Medial Sural Artery Perforator Flap and Its Application in Repairing Oropharyngeal Defects after Operation

目的:探讨腓肠肌内侧动脉穿支皮瓣在修复口咽恶性肿瘤术后缺损的临床应用。方法:在5具尸体上对腓肠肌区域进行模拟手术解剖出主要供血血管及穿支,用Image-Pro Plus 6.0软件对解剖图片进行分析。2020年9月~2022年9月,8例口咽部恶性肿瘤术后缺损,使用腓肠肌内侧动脉穿支皮瓣进行修复。结果:腓肠肌内侧动脉穿支皮瓣血管蒂平均长度(10.82±0.89) cm,腓肠肌内侧动脉起始端血管平均直径为(3.13±0.31) mm。共8例口咽部恶性肿瘤患者采用腓肠肌内侧动脉穿支皮瓣修复术后缺损,所有皮瓣均完全成活,供区术后无明显并发症。结论:腓肠肌内侧动脉穿支皮瓣可取血管蒂长,管径合适,供区无明显并发症,是修复口咽部恶性肿瘤术后缺损的较佳选择。

Objective:To investigate the clinical application of medial sural artery perforator flap in repairing postoperative defects of oropharyngeal malignant tumors.Methods:The main blood supply vessels and perforating branches were dissected by simulated operation on the sural muscle region of 5 specific cadavers,and the anatomical images were analyzed by Image-Pro Plus6.0 software.From September 2020 to September 2022,8 cases of oropharyngeal malignant tumors were repaired with medial gastrocnemius artery perforator flaps.Results:The mean vascular pedicle length of the medial sural artery perforator flap was(10.82±0.89)cm,and the mean vascular diameter of the starting end of the medial sural artery was(3.13±0.31)mm.A total of 8 patients with oropharyngeal malignant tumors were repaired with medial sural artery perforator flaps.All flaps survived completely,and there were no obvious postoperative complications at the donor site.Conclusion:The medial sural artery perforator flap is a good choice for repairing the defect after oropharyngeal malignant tumor surgery with long pedicle,suitable diameter,and no obvious complications in donor site.