CAJ | 학술논문

目的探讨应用个体化设计的游离股前外侧复合肌皮瓣,修复舌癌根治术后舌及口底缺损的效果.方法 2006年至2008年应用个体化设计的游离股前外侧复合肌皮瓣,修复31例舌癌根治术后舌及口底缺损,22例皮瓣的穿支血管类型为肌皮穿支,9例为肌间隙穿支;皮瓣大小为(4～8)cm×(5～10)cm,所携带股外侧肌大小为(2～5)cm×(3～6)cm,血管蒂的长度为(6.81±3.23)cm.结果 31例游离股前外侧复合肌皮瓣手术均获成功,舌外形及功能恢复良好,口底及下颌下区饱满;受区及供区伤口一期愈合,未发现口底瘘、下肢运动和感觉功能障碍等并发症,经1～3年的随访,28例无瘤生存,外观及功能满意,2例因术后出现对侧颈淋巴结转移再次手术;1例术后因远处转移死亡.结论个体化设计的游离股前外侧复合肌皮瓣具有可重建良好的舌及口底形态,恢复舌功能,供区部位隐蔽和并发症少等优点,是修复舌癌根治术后舌及口底缺损的理想的首选皮瓣.
목적 탐토응용개체화설계적유리고전외측복합기피판,수복설암근치술후설급구저결손적효과.방법 2006년지2008년응용개체화설계적유리고전외측복합기피판,수복31례설암근치술후설급구저결손,22례피판적천지혈관류형위기피천지,9례위기간극천지;피판대소위(4～8)cm×(5～10)cm,소휴대고외측기대소위(2～5)cm×(3～6)cm,혈관체적장도위(6.81±3.23)cm.결과 31례유리고전외측복합기피판수술균획성공,설외형급공능회복량호,구저급하합하구포만;수구급공구상구일기유합,미발현구저루、하지운동화감각공능장애등병발증,경1～3년적수방,28례무류생존,외관급공능만의,2례인술후출현대측경림파결전이재차수술;1례술후인원처전이사망.결론 개체화설계적유리고전외측복합기피판구유가중건량호적설급구저형태,회복설공능,공구부위은폐화병발증소등우점,시수복설암근치술후설급구저결손적이상적수선피판.
Objective To investigate the application of individualized free anterolateral thigh combined flap (ALTCF) for tongue and mouth floor defect resulted from tongue carcinoma. Methods From 2006 to 2008, individualized ALTCFs were used in 31 cases of tongue and mouth floor defects resulted from tongue carcinoma. The nutritional perforator vessel was musculocutaneous pattern in 22 cases and septocutaneous pattern in 9 cases. The size of the flaps and the included muscle was (4～8) cm×(5～10) cm and (2～5) cm × (3～ 6) cm, respectively. The length of blood vessel pediclc was (6.81±3.23) cm. Results All the 31 free flaps survived with primary healing and no complication. The appearance and function were both satisfactory. During the follow-up period of 1～3 years, 28 cases survived, 2 cases were reoperated due to the neck lymphatic metastais on the contralateral side. 1 case died of distant metastasis. Conclusions Individualized ALTCF is a reliable flap for the tongue and month floor defects resulted from tongue carcinoma. Both the cosmetic and functional results are satisfactory with less morbidity in donor site and less complication.