CAJ | 학술논문

目的探讨口底癌术后缺损修复重建的方法及适应证.方法回顾性分析2003年7月至2013年3月间,中南大学湘雅医学院附属肿瘤医院头颈外科收治并同期修复重建的106例口底癌患者的临床资料,评价其修复方法.结果术后随访2个月至10年,全组患者的3年生存率为63.6％(42/66),5年生存率为57.7％(30/52).有1例患者因胸锁乳突肌肌皮瓣坏死择期改行胸大肌肌皮瓣修复成功；1例患者带状肌肌皮瓣部分坏死,经清创换药后创面愈合；3例患者游离皮瓣术后皮瓣危象,经急诊探查抢救成功；其余修复者均愈合良好.106例患者进食及语言功能均能满足一般生活需要.结论口底癌依据病情、缺损范围以及患者体质等因素,在根治肿瘤的同时,决定具体的修复方法.一般情况下不建议行邻近带蒂组织瓣.口腔修复膜、游离前臂皮瓣、游离股前外侧皮瓣、胸大肌肌皮瓣和游离腓骨皮瓣基本能满足各类口底癌术后缺损的修复.
목적 탐토구저암술후결손수복중건적방법급괄응증.방법 회고성분석2003년7월지2013년3월간,중남대학상아의학원부속종류의원두경외과수치병동기수복중건적106례구저암환자적림상자료,평개기수복방법.결과 술후수방2개월지10년,전조환자적3년생존솔위63.6％(42/66),5년생존솔위57.7％(30/52).유1례환자인흉쇄유돌기기피판배사택기개행흉대기기피판수복성공；1례환자대상기기피판부분배사,경청창환약후창면유합；3례환자유리피판술후피판위상,경급진탐사창구성공；기여수복자균유합량호.106례환자진식급어언공능균능만족일반생활수요.결론 구저암의거병정、결손범위이급환자체질등인소,재근치종류적동시,결정구체적수복방법.일반정황하불건의행린근대체조직판.구강수복막、유리전비피판、유리고전외측피판、흉대기기피판화유리비골피판기본능만족각류구저암술후결손적수복.
Objective To explore the reconstruction approaches and indications in repairing of postoperative defect after resection of oral floor carcinoma.Methods To review the clinical data of 106 patients with oral floor carcinoma treated by radical resection with simultaneous reconstruction in the Department of Head and Neck Surgery at our hospital from July 2003 to March 2013,and to evaluate the advantages and disadvantages of various repair methods.Results The patients were followed up for 2 months to 10 years.Their 3-year survival rate was 63.6％ (42/66) and 5-year survival rate was 57.7％ (30/52).One case had sternocleidomastoid myocutaneous flap necrosis,and was successfully repaired with elective pectoralis major myocutaneous flap.Another one case showed partial strap muscle flap necrosis,and the wound was well healed after debridement and dressing changes.Three cases of free flap crisis because of poor blood supply were successfully cured by flap emergency exploration.The rest were well healed.The eating and language function of the patients could meet the general needs of life.Conclusions At the time of radical resection of oral floor carcinoma,an appropriate repair method should be selected according to many factors such as disease conditions,defect size,patients' physical constitution,etc.Generally,adjacent pedicle flap is not recommended.Prosthodontics membrane,free forearm flap,free anterolateral thigh flap,pectoralis major myocutaneous flap and free fibula flap can basically meet the need of repair of the postoperative defect after resection of oral floor carcinoma,therefore,are recommended.