胸三角皮瓣切开重建胸大肌肌皮瓣在口腔癌手术治疗中的应用

M. M. Davudov, I. Harirchi, Z. Mirzajani
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引用次数: 1

摘要

背景:口腔癌手术切除后组织缺损的重建是患者管理的主要目标之一。多种皮瓣用于此目的,最常见的是胸大肌肌皮瓣(PMMF)。该皮瓣目前广泛应用于头颈部各种缺损的重建。方法:2011-2017年在阿塞拜疆医科大学第一市立医院和外科培训诊所对29例口腔鳞状细胞癌患者行原发肿瘤手术切除及颈部清扫术。PMMF用于三角胸肌瓣切口缺损的重建。结果:22例患者(75.8%)在PMMF后发生了原发性愈合。4例(13.8%)患者出现PMMF坏死,并被带回手术室用三角胸肌瓣进行二次重建。在3例(10.3%)患者中,皮瓣的皮肤发生坏死,导致口皮瘘的发展。结论:应用PMMF配合三角瓣切口,可获得三角瓣。这个皮瓣可以在早期使用,或者如果PMMF失败。
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Pectoralis Major Myocutaneous Flap Reconstruction with Deltopectoral Flap Incision in the Surgical Treatment of Oral Cancer
Background: One of the main goals of patient management is the reconstruction of tissue defects following surgical resection for oral cancer. A variety of flaps used for this purpose, the most frequent being a Pectoralis Major Myocutaneus Flap (PMMF). This flap is currently widely used for the reconstruction of different defects of the head and neck. Methods: Surgical resection of the primary tumor, as well as neck dissection, performed on 29 patients with oral squamous cell carcinoma between 2011–2017 in City Hospital #1 and Surgical Training Clinic of Azerbaijan Medical University. PMMF used for the reconstruction of defects using a deltopectoral flap incision. Results: In 22 patients (75.8 %) primary healing occurred following a PMMF. Four patients (13.8 %) suffered PMMF necrosis and were took back to the operating room for secondary reconstruction with a deltopectoral flap. In three patients (10.3%) the skin of the flap underwent necrosis, resulting in the development of an orocutaneous fistula. Conclusion: Use of PMMF with deltopectoral flap incision enables deltopectoral flap availability. This flap can then used early on or if PMMF fails.
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