Abstract：
Scapular tip flaps (STF) may be used as an alternative to traditional methods of reconstruction of head and neck cancer (HNC) defects. This study aimed to establish the success and complication rates for STF in HNC reconstruction. A literature search was conducted on PubMed, BMJ Journals, DARE, EMBASE databases and Cochrane (CENTRAL) register. (Registry CRD42023428012). A total of 23 studies fulfilled the inclusion criteria with 474 patients who underwent reconstructive procedures using the STF. 100% of STF used were free flaps (STFFs). The most common reason for reconstruction was following malignancy (81.4%, n = 386). The pooled success rates in all studies using scapular tip flaps in head and neck reconstruction was 99% (95% CI, 97 to 100, p = 1.00; I2 = 0). Pooled total complication rates were 38% (95% CI, 25 to 51, p < 0.01; I2 = 90%). 19.6% required return to theatre with only 1.5% being for repeat flap coverage. The STF demonstrated an overall success rate of 99%. This is higher than other documented success rates with mainstay flaps for HNC defect reconstruction. Complication and re-operation rates were also like recorded rates. This review demonstrates the advantage of STF as a safe and versatile reconstructive option for HNC related defects. Evaluation of the literature is limited by poor-quality studies and comparability bias.
摘要：
肩胛骨尖端皮瓣（STF）可用作传统方法重建头颈部癌（HNC）缺损的替代方法。本研究旨在确定STF在HNC重建中的成功率和并发症发生率。在PubMed上进行了文献检索，BMJ期刊,DARE,EMBASE数据库和Cochrane(CENTRAL)寄存器。（注册表CRD42023428012）。共有23项研究符合纳入标准，其中474例患者接受了使用STF的重建手术。100%使用的STF是游离皮瓣(STFFs)。重建的最常见原因是恶性肿瘤（81.4％，n=386)。在所有使用肩胛骨尖端皮瓣进行头颈部重建的研究中，合并成功率为99％（95％CI，97至100，p=1.00；I2=0）。合并总并发症发生率为38%(95%CI,25~51,p<0.01;I2=90%)。19.6％的人需要返回剧院，只有1.5％的人需要重复皮瓣覆盖。STF的总体成功率为99%。这比其他记录的用于HNC缺损重建的主要皮瓣的成功率更高。并发症和再次手术率也与记录率相似。这篇综述证明了STF作为HNC相关缺陷的安全和通用重建选择的优势。对文献的评价受到低质量研究和可比性偏差的限制。
