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目的探讨游离腹壁下动脉穿支皮瓣应用在舌癌术后缺损修复与舌再造中的效果。方法 2008年12月~2016年1月应用游离腹壁下动脉穿支皮瓣对42例舌癌患者行舌癌根治术同期行舌口底缺损修复与舌再造,其中舌缘癌22例,舌腹癌17例,口底癌累及舌3例,肿瘤根治术后形成6.5 cm×3.5 cm~11.0 cm×7.5 cm大小缺损。术中将腹壁下动脉与甲状腺上动脉吻合,伴行静脉与甲状腺上静脉或颈内静脉吻合。结果皮瓣长(8.6±0.3)cm、宽(5.1±0.2)cm、厚(2.3±0.5)cm。腹壁下动脉穿支皮瓣血管蒂长度为(9.6±0.4)cm。42例肌皮瓣全部存活,供区直接闭合。皮瓣外观满意,供区仅遗留线性瘢痕,腹直肌功能未见明显影响。随访14~64个月。再造舌形态良好,吞咽、语言功能满意,肿瘤局部无复发。结论腹壁下动脉穿支皮瓣组织量丰富,质地好,再造舌外形及功能良好,供区损伤小,是舌癌术后舌、口底缺损修复与舌再造的理想选择。
Objective To investigate the application of free inferior abdominal artery perforator flap in the repair of tongue cancer and tongue reconstruction. METHODS: From December 2008 to January 2016, 42 patients with tongue cancer underwent radical radical resection of tongue mouth and 42 patients with tongue tongue defect. Twenty-two patients with tongue-edge cancer, tongue 17 cases of carcinoma, 3 cases of mouth cancer involving the tongue, and 6.5 cm × 3.5 cm ~ 11.0 cm × 7.5 cm defects after radical operation. Intraoperative abdominal artery and thyroid artery anastomosis, accompanied by vein and thyroid vein or internal jugular vein anastomosis. Results The flap length was (8.6 ± 0.3) cm, width (5.1 ± 0.2) cm and thickness (2.3 ± 0.5) cm. The length of vascular pedicle of the perforating branch of inferior abdominal artery was (9.6 ± 0.4) cm. 42 cases of myocutaneous flap all survived for the area directly closed. The appearance of the flap was satisfactory, leaving only a linear scar for the area, no significant effect of rectus abdominis function. Follow-up 14 to 64 months. Reconstruction of the tongue morphology, swallowing, language features satisfactory, no recurrence of tumor local. Conclusions The perforating branch of inferior abdominal artery is rich in tissue volume, good texture, good reconstruction of tongue shape and good function, and small area damage. It is an ideal choice for reconstruction of tongue and mouth defect and tongue reconstruction after tongue cancer operation.