Abstract：
Reconstruction after wide resection of a sarcoma arising in the shoulder girdle is challenging, and little evidence is available to compare short-term outcomes between pedicled-flap and free-flap reconstruction.
Thirty-eight patients undergoing immediate reconstruction surgery with only a pedicled-flap (n = 18) and with a free-flap (n = 20) after sarcoma resection on the shoulder girdle between July 2005 and March 2022 were identified. One-to-one propensity score matching was performed to compare the postoperative complications.
Transferred flaps survived completely in 20 cases in the free-flap group. In the all-patient analysis of binary outcomes, the occurrences of total complications, takebacks, total flap complications, and flap dehiscence were higher in the pedicled-flap group than in the free-flap group. The propensity score-matched analysis showed the occurrence of total complications was significantly higher in the pedicled-flap group than the free-flap group (53.8% vs. 7.7%, p = 0.03). In the propensity score-matched analysis of continuous outcomes, the pedicled-flap group demonstrated a shorter operation time than the free-flap group (279 vs. 381 min, p = 0.05).
This clinical study demonstrated the feasibility and reliability of a free-flap transfer for the defect after wide resection of a sarcoma arising in the shoulder girdle.
Thirty-eight patients undergoing immediate reconstruction surgery with only a pedicled-flap (n = 18) and with a free-flap (n = 20) after sarcoma resection on the shoulder girdle between July 2005 and March 2022 were identified. One-to-one propensity score matching was performed to compare the postoperative complications.
Transferred flaps survived completely in 20 cases in the free-flap group. In the all-patient analysis of binary outcomes, the occurrences of total complications, takebacks, total flap complications, and flap dehiscence were higher in the pedicled-flap group than in the free-flap group. The propensity score-matched analysis showed the occurrence of total complications was significantly higher in the pedicled-flap group than the free-flap group (53.8% vs. 7.7%, p = 0.03). In the propensity score-matched analysis of continuous outcomes, the pedicled-flap group demonstrated a shorter operation time than the free-flap group (279 vs. 381 min, p = 0.05).
This clinical study demonstrated the feasibility and reliability of a free-flap transfer for the defect after wide resection of a sarcoma arising in the shoulder girdle.
摘要：
背景：肩带肉瘤广泛切除后的重建具有挑战性，几乎没有证据可以比较带蒂皮瓣和游离皮瓣重建的短期结果。
方法：在2005年7月至2022年3月期间，在肩带肉瘤切除后，38例患者接受了仅带蒂皮瓣（n=18）和游离皮瓣（n=20）的立即重建手术。进行一对一的倾向评分匹配以比较术后并发症。
结果：游离皮瓣组转移皮瓣20例完全成活。在二元结果的全患者分析中，总并发症的发生，takeback,总皮瓣并发症，带蒂皮瓣组皮瓣裂开率高于游离皮瓣组。倾向评分匹配分析显示，带蒂皮瓣组的总并发症发生率明显高于游离皮瓣组（53.8%vs.7.7%,p=0.03)。在连续结果的倾向得分匹配分析中，带蒂皮瓣组的手术时间短于游离皮瓣组（279vs.381分钟,p=0.05)。
结论：这项临床研究证明了在广泛切除肩带肉瘤后对缺损进行游离皮瓣转移的可行性和可靠性。
方法：在2005年7月至2022年3月期间，在肩带肉瘤切除后，38例患者接受了仅带蒂皮瓣（n=18）和游离皮瓣（n=20）的立即重建手术。进行一对一的倾向评分匹配以比较术后并发症。
结果：游离皮瓣组转移皮瓣20例完全成活。在二元结果的全患者分析中，总并发症的发生，takeback,总皮瓣并发症，带蒂皮瓣组皮瓣裂开率高于游离皮瓣组。倾向评分匹配分析显示，带蒂皮瓣组的总并发症发生率明显高于游离皮瓣组（53.8%vs.7.7%,p=0.03)。在连续结果的倾向得分匹配分析中，带蒂皮瓣组的手术时间短于游离皮瓣组（279vs.381分钟,p=0.05)。
结论：这项临床研究证明了在广泛切除肩带肉瘤后对缺损进行游离皮瓣转移的可行性和可靠性。
