桡骨皮瓣在头颈部肿瘤切除后缺损修复中的应用

M. Kropotov, V. Sobolevsky, L. Yakovleva, A. V. Khodos, O. A. Saprina, D. Safarov
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摘要

介绍。第一阶段的手术一直是几乎所有地方局部晚期头癌的金标准治疗。这类患者通常有明显的术后缺陷,导致严重的功能和审美障碍。这需要同时修复缺陷。缺陷修复技术的选择应仔细考虑其效益和潜在的后果。目的:评价带血管重建的桡骨皮瓣在头颈部肿瘤联合广泛切除后缺损修复中的应用效果。材料和方法。本研究包括67例不同部位的头颈部癌症患者,均行手术切除肿瘤后再用桡骨皮瓣修复。所有患者均采用桡骨自体移植物修复缺损。由于本研究主要包括口腔和口咽肿瘤患者(53例),我们也分析了该队列的生存率。患者随访2 ~ 7年。14例患者(26.4%)在此期间病情进展,包括8例复发原发肿瘤患者和6例局部转移患者。取出鼻食管探头并恢复吞咽的平均时间为12.2 d;平均住院时间为13.5 d。因此,桡骨皮瓣是一种可靠的、多功能的材料,可用于修复头颈部肿瘤患者的复杂和复合性缺损。在某些情况下,这是一种选择方法,因为它有助于实现令人满意的生活质量。舌形皮瓣修复舌形缺损可保证良好的功能效果。
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Utility of radial flaps for defect repair after surgical excision of head and neck tumors
Introduction. Surgery at the first stage has always been the gold-standard treatment for locally advanced head cancer of almost all locations. Such patients often have significant postoperative defects that cause serious functional and aesthetic disorders. This requires simultaneous defect repair. The technique of defect repair should be chosen carefully with the consideration of its benefits and potential consequences.Objective – to evaluate the efficacy of revascularized radial flaps for defect repair after combination extensive surgical excisions of head and neck tumors.Materials and methods. This study included 67 patients with head and neck cancers of different locations who had undergone surgical tumor excision followed by defect repair using a radial flap.Results. All patients had their defects repaired using radial autologous grafts. Since this study included primarily patients with oral and oropharyngeal tumors (53 patients), we also analyzed the survival in this cohort. patients were followed-up for 2 to 7 years. fourteen patients (26.4 %) developed progressive disease during this time, including 8 individuals with recurrent primary tumor and 6 individuals with regional metastases. The mean time to nasoesophageal probe removal and restored swallowing was 12.2 days; mean length of hospital stay was 13.5 days.Conclusion. Thus, radial flap is a reliable and multifunctional material that can be used to repair complex and combination defects in patients with head and neck tumors. In some cases, it is the method of choice, since it helps to achieve satisfactory quality of life. Repair of tongue defects with radial flaps ensures good functional results.
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