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題名 | 自由皮瓣在頭頸惡性腫瘤之應用=Application of Free Flaps in Head & Neck Malignancy |
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作者 | 羅正興; 蔡喬薏; 鄭聿真; 李芳輝; Lo, Cheng-hsing; Tsai, Chou-yi; Chen, Yu-jeng; Lee, Fang-hui; |
期刊 | 中華民國口腔顎面外科學會雜誌 |
出版日期 | 20030900 |
卷期 | 14:2 2003.09[民92.09] |
頁次 | 頁119-135 |
分類號 | 416.954 |
語文 | chi |
關鍵詞 | 自由皮瓣; 翻轉皮瓣; Free flap; Rotation flap; |
中文摘要 | 頭頸部惡性腫瘤經廣泛性切除後若缺損過大,則應以自由皮瓣為第一考量來解決重建的問題。本科自民國90年2月至92年3月共有28位患者,32例自由皮瓣應用在頭頸部惡性腫瘤切除後之重建。28位患者中2位女性,26位男性,平均年齡51.2歲。惡性腫瘤細胞分類:27位鱗狀上皮細胞癌,1位為腺囊癌。病性處:頰側15位,舌部4位,下牙齦3位,口咽2位,下唇2位,頸部2位,口底1位,上顎1位,下品顳區 (Infra-temporal) 1位,顳區(Temporal) 1位。自由皮瓣之選擇: 21位橈倒前臂筋膜皮瓣,8位背闊肌皮瓣, 3位為腓骨肌皮瓣。受植區 (Recipient site) 之動靜脈血管吻合:上甲狀腺動脈15例,外頸動脈8例,面動脈5例,舌動脈2例,橫頸動脈及淺顯動脈各1例;靜脈血管吻合:外頸靜脈17例,內頸靜脈12例,前頸靜脈、下顎後靜脈及淺顯靜脈各1例。皮瓣喪失3例,總成功率為91%。手術後傷口感染無,但皮瓣瘻管有2例,全身性併發症3例,1例死亡。手術時間平均14.3小時,加護病房 7.6日,平均住院日為26.4日。 |
英文摘要 | The mainstream of reconstructive methods for head and neck malignancy after tumor ablation are free flaps. The advantages of free flaps are: 1) no limitatiοn of use for whatever location of defects in head and neck region; 2) one can choose proper free flap to fit any type of defect like size, thickness and including bone or not; 3) the cosmetic problem is better than use of pedicle flap. The aim of this study is going to present the result for reconstruction of defects with free flaps in head and neck malignancy after tumor ablation. In St Martin De Porres Hospital From February 2001 to March 2003, 32 free flaps were done on 28 patients. 2 females, 26 males. Mean age 51.6 y/o. The majority of cancer cells are squamous cell carcinoma. 3.5X loupe used for f1apdissection; Leica M680 used for vessels anastomosis. The surgical defects are as following: Buccal cheek 15 cases, Tongue 4 cases, Lower gingival 3 cases, Oropharyngeal 2 cases, Lower lip 2 cases, Neck 2 cases, Mouth floor1 case, Maxilla 1 case, Infratemporal 1 case, Temporal 1 case. Flaps used for reconstruction are: Radial forearm 21 cases, Latissimus dorsi 8 cases, Peroneal 3. cases. The most common use of artery for anastomosis is superior thyroid artery, vein for anastomosis is external jugular vein. Result: mean operation time 14.3 hrs, re-exploration in 24 hrs 7 cases, ICU 7.6 days, total hospital duration 26.4 days, overall success rate 91 %. |
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