Microvascular Anastomosing Free Flap for the Reconstruction of Oral Cancer

顯微血管吻合自由瓣用於口腔癌之重建手術

黃澤人(Tzer-Zen Hwang) ； 蔡森田(Sen-Tien Tsai) ； 李經維(Jing-Wei Lee) ； 邱浩遠(Haw-Yen Chiu)

《中華民國耳鼻喉科醫學會雜誌》 29卷6期 (1994/12) Pp. 512-524

https://doi.org/10.6286/1994.29.6.512

摘要

Microvascular free flap reconstruction was applied in 21 patients with oral cancer. There were 20 males and 1 female with a mean age of 51.8 years. Most of the patients had the history of cigarette smoking, alcohol consumption, and betel nut chewing. All the patients had an ASA classification scale of II or III. The primary tumors were located in the buccal mucosa (14 patients), oral tongue (4 patients), lower alveolar ridge (2 patients), and retromolar trigone (1 patient). Four patients had prior radiotherapy. Ten patients received induction chemotherapy. The most common used flap for reconstruction was the radial forearm flap (16 patients), followed by the latissimus dorsi flap (3 patients), the rectus abdominis flap (1 patient), and the dorsalis pedis flap (1 patient). Bipaddled flap or combined flap was successfully used for reconstruction of the through-and-through defect in 8 of the 14 buccal cancer patients (57.1%). The most common medical complication was upper G-I bleeding (28.6%). The majority of the surgical complications were minor problems. Only one total flap loss (4.8%) was experienced. The average intraoral healing time was 19.9 days. The planned postoperative radiotherapy was never postponed due to delay intraoral healing or other complications. Analysis of the influence of multiple risk factors on the postoperative complication was performed. None of the factors was statistically significant. We regard microvascular free flap reconstruction a reliable and ideal procedure for oral cancer.

並列摘要

我們以微血管自由瓣應用於21例口腔癌患者的重建手術，其中20例男性，1例女性，平均年齡51.8歲。大多數均有抽煙、喝酒、嚼檳榔的嗜好。患者的身體狀態依據ASA classification scale 都為II或III。腫瘤原發部位如下：頰部黏膜(14例)，舌可動部(4例)，下齒槽脊(2例)，臼齒後三角(1例)。有4例患者先前接受過放射線治療，10例患者接受過引導性化學療法。最常使用的自由瓣是橈側前臂瓣(16例)，其次是：背闊肌瓣(3例)，腹直脊瓣(1例)，足背瓣(1例)。8例(57.1%)頰部黏膜癌的患者有黏膜至皮膚的全層缺損，這些缺損都成功地以雙層瓣或複合瓣予以重建。最常發生的內科併發症是上消化道出血，有28.6%。大多數的外科併發症均很輕微。我們只經驗1例全瓣壞死(4.8%)。平均口腔內癒合時間為19.9天。術後放射治療均未因口腔內癒合較慢或其它的術後併發症而延後。分析多個可能增加術後併發症發生機率的危險因子，發現所有這些因子都沒有明顯增加術後併發症的現象。我們認為微血管自由瓣運用於口腔癌的重建手術，是一個可靠、理想而值得推廣的模式。

並列關鍵字

free flap reconstruction ； oral cancer