CAJ | 학술논문

目的：探讨游离股前外侧肌皮瓣在中晚期口底癌术后缺损修复重建中的治疗效果及CT血管造影（CTA）定位股前外侧肌皮瓣穿支血管的应用价值。方法对16例中晚期口底癌患者在施行口底癌根治性切除术同时运用游离股前外侧肌皮瓣行软组织缺损的修复重建，术前应用CTA定位旋股外侧动脉及穿支血管。结果16例患者术前CTA定位的穿支血管与术中所见完全吻合，股前外侧肌皮瓣移植手术均获成功。术后随访6~36个月，患者的口底、舌外形恢复良好，张口度理想，吞咽及语言功能满意，供区无明显后遗症，肿瘤局部无复发，其中1例患者（T4N2M0期）在术后10个月因发生远处转移而死亡。结论 CTA能精确定位旋股外侧动脉及穿支血管，游离股前外侧肌皮瓣是修复重建中晚期口底癌术后组织缺损的理想选择。
목적：탐토유리고전외측기피판재중만기구저암술후결손수복중건중적치료효과급CT혈관조영（CTA）정위고전외측기피판천지혈관적응용개치。방법대16례중만기구저암환자재시행구저암근치성절제술동시운용유리고전외측기피판행연조직결손적수복중건，술전응용CTA정위선고외측동맥급천지혈관。결과16례환자술전CTA정위적천지혈관여술중소견완전문합，고전외측기피판이식수술균획성공。술후수방6~36개월，환자적구저、설외형회복량호，장구도이상，탄인급어언공능만의，공구무명현후유증，종류국부무복발，기중1례환자（T4N2M0기）재술후10개월인발생원처전이이사망。결론 CTA능정학정위선고외측동맥급천지혈관，유리고전외측기피판시수복중건중만기구저암술후조직결손적이상선택。
Objective The?aim?of?this?study?was?to?investigate?the?value?of?free?anterolateral?thigh?myocutaneous?flap?(ALTMF)?and?computed?tomography?angiography?(CTA)?for?the?reconstruction?of?mouth-floor?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.?Methods???Sixteen?cases?of?middle-late?stage?carcinomas?of?the?mouth?floor?underwent?radical?resection,?and?mouth-floor?and?tongue?defects?were?reconstructed?with?ALTMF.?CTA?was?applied?to?plan?the?lateral?circumflex?femoral?artery?(LCFA)?and?its?perforating?vessel,?which?was?verified?during?the?operation.?Results???The?position?of?the?perforating?vessel?in?the?operation?was?fully?consistent?with?that?designed?by?the?preoperative?CTA.?All?16?flaps?completely?survived.?The?appearance?and?function?of?all?cases?were?both?satisfactory.?All?donor?sites?were?primarily?closed?and?healed?without?functional?morbidity.?During?the?follow-up?period?of?6–36?months,?15?cases?survived?with?acceptable?aesthetic?and?functional?results?in?mouth?floor?and?tongue?reconstruction,?except?for?1?case?(T4N2M0)?that?died?of?metastasis?carcinoma?10?months?after?operation.?Conclusion???CTA?can?accurately?locate?the?LCFA?and?artery?perforator.?Preoperative?perforator?planning?using?CTA?in?ALTMF?transplantation?is?a?reliable?and?useful?method?thatresults?in?safe?operation?with?optimal?outcome.?The?ALTMF?is?an?ideal?choice?for?the?reconstruction?of?soft?tissue?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.