胸大肌肌皮瓣修复口腔口咽癌手术后组织缺损  

Pectoralis Major Myocutaneous Flap for Repairing Large Tissue Defects Caused by Surgery for Oro-pharyngeal Cancer

作　　者：王治平[1] 艾伟健[1] 赵建江[1] 郑俊发[1] 刘曙光[1] 周会喜[1] 栾修文[1] 李志强[1] 

机构地区：[1]广东省口腔医院暨南方医科大学附属口腔院口腔颌面外科,510280

出　　处：《中国肿瘤临床》2011年第1期33-35,共3页Chinese Journal of Clinical Oncology

基　　金：2006年国家自然科研基金资助(编号:30672340);广东省科技计划项目(编号:2008B030301183);广东省医学科研基金资助(编号:A2009097)~~

摘　　要：目的:总结胸大肌岛状肌皮瓣应用于口腔口咽癌手术所致大型组织缺损的体会及其应用价值。方法:对51例因口腔癌或口咽癌手术治疗导致口腔颌面大型组织缺损的患者均选用胸大肌岛状肌皮瓣同期整复。结果:51例胸大肌肌皮瓣中43例完全成活,1例肌皮瓣皮肤完全坏死,7例远心端部分皮肤坏死。所有组织缺损,伤口愈合,患者术后语音和吞咽功能得到修复。结论:胸大肌肌皮瓣解剖变异较小,血供可靠,皮瓣制作简便安全,组织量大,是同期整复口腔颌面部大型组织缺损合适材料。Objective： To summarize the value of the island myocutaneous flap using a major pectoral muscle applied for large tissue defects after surgery for oro-pharyngeal cancer. Methods： In our hospital, 51 patients with oro-pharyngeal cancer had surgery in the last three years. Pectoralis major myocutaneous flaps were prepared and applied to synchronously repair the large soft tissue defects. The reconstruction size ranged from 7cm ×5cm to 8cm× 12cm and the length of the pedicle was from 12cm to 17cm. Data from the surgery including defect description, size of the myocutaneous flap and complications were collected. Results： All patients recovered well after surgery. In 43 of the 51 cases, pectoralis major myo-cutaneous flaps were completely alive. In the other 8 cases, partial flap necrosis at the distal end occurred in 7 cases and necrosis of the total myocutaneous flap was found in one case, but the pedicle at the neck was fine. Vocal and swallowing functions were recovered well in all cases. Pneumothorax occurred in one case during surgery. Four patients had subcuta- neous emphysema after surgery. Five patients suffered from other complications, but the symptoms were controllable. All patients were followed up for 6 to 36 months. Eight patients died within 18 months postoperatively from recurrence. Conclusion： Pectoralis major myocutaneous flap can be used for repairing the defects from surgery in the oro-pharyngeal region immediately. It is safe and reliable, due to the excellent blood supply and abundant tissue. It can be used in patients with a poor vascular status or advanced age.

关 键 词：口腔口咽癌胸大肌肌皮瓣组织缺损整复 

分 类 号：R739.8[医药卫生—肿瘤]