游离股动脉蒂穿支皮瓣在口颊癌术后缺损修复中的临床应用
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1.长沙市第四医院;2.湖南省肿瘤医院肿瘤整形外科

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Clinical application of free femoral artery pedicled perforator flap in the repair of postoperative defects of oral and buccal cancerPeng Ya1, SONG Dajiang2,SLI Zan2
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    摘要:

    目的 探讨游离股动脉穿支皮瓣的临床解剖及其在口颊癌术后缺损修复中的应用。 方法 2015年12月-2019年6月采用游离股动脉穿支皮瓣对13例口颊癌患者行口颊修复,全部为男性患者,年龄37~61岁,平均48.5岁。病理类型均为鳞状细胞癌,按国际抗癌联盟(UICC)TNM 分期:T4N0M0 5例,T4N1M02例,T3N1M02例,T3N2M04例。病程3~16个月,平均9.8个月。游离股动脉穿支皮瓣具体切取形式包括:①单纯穿支皮瓣7例,②穿支嵌合肌皮瓣6例。 结果 皮瓣切取范围为6.5cm×4.0cm~10.0cm×6.5cm,皮瓣厚度为2.5~3.5 cm。股动脉穿支血管蒂长度为(6.2±0.4)cm,大腿内侧供区均直接拉拢缝合。13例皮瓣全部存活,供受区创面及切口均Ⅰ期愈合。所有患者均获随访,随访时间12~30个月,平均21.3个月。重建口颊外形不臃肿,无毛发生长,功能满意,肿瘤局部无复发,2例发生颈部淋巴结转移。供区仅遗留线性瘢痕,大腿功能未见明显影响。 结论 游离股动脉穿支皮瓣可以用于口颊癌根治术后的口颊缺损修复。

    Abstract:

    Objective To investigate the clinical anatomy of free femoral artery perforator flap and its application in the repair of postoperative defects of oral and buccal cancer. Methods From December 2015 to June 2019, 13 patients with orobuccal cancer underwent orobuccal repair with free femoral artery perforator flap, all male patients, aged 37 ~ 61 years, with an average of 48.5 years. The pathological types were squamous cell carcinoma. According to the TNM stage of UICC, there were 5 cases of T4N0M0, 2 cases of T4N1M0, 2 cases of T3N1M0 and 4 cases of T3N2M0. The course of disease was 3 ~ 16 months, with an average of 9.8 months. The harvestion forms of free femoral artery perforator flap include: ① simple perforator flap in 7 cases, ② perforator chimeric myocutaneous flap in 6 cases. Results The size of the flap ranged from 6.5cm×4.0cm to 10.0cm×6.5cm. The thickness of the flap was 2.5 to 3.5 cm. The length of the vascular pedicle was (6.2 ± 0.4) cm, and the donor site of the medial thigh was directly closed. All 13 flaps survived, and the wounds healed smoothly. All patients were followed up for 12 ~ 30 months, with an average of 21.3 months. The reconstructed buccal shape was not bulky, there was no hair growth, the function recovery was satisfactory, there was no local recurrence of the tumor, and 2 cases had cervical lymph node metastasis. Only linear scar was left in the donor area, and there was no significant effect on thigh function. Conclusions Free femoral artery perforator flap can be used to repair buccal defect after radical resection of buccal cancer.

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  • 收稿日期:2022-03-05
  • 最后修改日期:2022-06-04
  • 录用日期:2022-07-15
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