经腋前线进路的延长节段性胸大肌肌皮瓣与常规方法修复口腔口咽癌缺损的疗效比较  

Comparison of the outcomes of an extensive segmental pectoralis major myocutaneous flap via the anterior axillary line and the conventional technique for reconstruction of defects after ablative surgery of oral and oropharyngeal cancers

作　　者：周斌[1] 庄秀妹[1] 陈伟良[1] 张大明[1] 王勋明 周家敏 ZHOU Bin;ZHUANG Xiu-mei;CHEN Wei-liang;ZHANG Da-ruing;WANG Xun-ruing;ZHOU Jia-min(Department of Oral and Maxillofacial Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University.Guangzhou 510120,Guangdong Province,China)

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面外科,广东广州510120

出　　处：《中国口腔颌面外科杂志》2018年第5期416-419,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81702695;81772888)

摘　　要：目的:比较经腋前线进路的延长节段性胸大肌肌皮瓣和常规方法制备胸大肌肌皮瓣在修复口腔口咽癌术区缺损的效果。方法:纳入口腔、口咽癌患者91例,所有患者均实施肿瘤根治手术,并采用经腋前线进路的延长节段性胸大肌肌皮瓣(51例)或常规方法制备胸大肌肌皮瓣(40例)转移修复术区缺损组织。结果:经腋前线进路的延长节段性胸大肌肌皮瓣和常规方法制备胸大肌肌皮瓣的血管蒂长度分别为22~28 cm和18~22 cm,皮岛大小分别为5 cm×8cm^7 cm×14 cm和6 cm×7 cm^8 cm×17 cm。术后随访6~36个月,经腋前线进路的延长节段性胸大肌肌皮瓣组患者的肩部活动度明显优于常规组,并且供区的美观性更佳。结论:与常规方法相比,延长节段性胸大肌肌皮瓣的蒂部更长,术后患者的肩部活动度与供区更美观,在口腔口咽癌术区组织缺损修复中值得推广应用。PURPOSE：To compare the outcomes of an extensive segmental pectoralis major myocutaneous flap（esPMMF）and a conventional pectoralis major myocutaneous flap（cPMMF） in reconstruction of defects after ablative surgery of oral and oropharyngeal cancers. METHODS： The study enrolled 91 patients with primary oral and oropharyngeal cancer who underwent radical resection, followed by reconstruction of the defect using either an esPMMF via the anterior axillary line or a cPMMF. RESULTS： The pedicle lengths of the esPMMF and cPMMF were 22-28 cm and 18-22 cm, respectively.The esPMMF and cPMMF had skin paddle dimensions of 5 cm ×8 cm to 7 cm ×14 cm and 6 cm ×7 cm to 8 cm ×17 cm,respectively. The range of shoulder abduction was significantly greater in the esPMMF group and the donor site esthetic results were better. CONCLUSIONS： esPMMF has a longer pedicle flap, enables a greater range of shoulder abduction,and has a better esthetic results than the conventional technique.

关 键 词：胸大肌皮瓣 口腔癌 口咽癌 肩部畸形 

分 类 号：R782.05[医药卫生—口腔医学]