PDF(Pubmed)
Abstract：
UNASSIGNED: This study aims to evaluate the factors most associated with early and late complications following microvascular free tissue transfer (MVFTT) after mandibulectomy.
UNASSIGNED: A retrospective review of patients undergoing MVFTT after segmental mandibulectomy from September 2016 to February 2021 was performed across a single academic institution. Surgical variables were collected, including the location of the resultant mandibular defect (anterior vs posterior) and flap type (osseous or non-osseous). The primary outcome variables included postoperative complications (early, <90 days; and late, >90 days) and the patients\' functional status (return to oral intake). Descriptive statistics, chi-square test, Fischer\'s exact test, and 2-sample t tests were used to analyze differences among variables.
UNASSIGNED: We analyzed a cohort of 114 consecutive patients with mandibular defects, comprising 57 anterior and 57 posterior defects. Bony free flaps with hardware were used to reconstruct 98% of anterior defects compared to 58% of posterior defects (P < .001). All soft tissue only flaps did not utilize any hardware during the reconstruction. Anterior defects demonstrated more late complications requiring additional surgery (30% vs 9%, P = .04). A secondary analysis of posterior mandibular reconstructions compared soft tissue only flaps and bony free flaps with hardware and showed equivalent rates of early (12% vs 13%, P > .99) and late (9% vs 8%, P > .99) complications requiring additional surgery while demonstrating a similar return to full oral competence (55% vs 46%, P = .52) and recovery of a 100% oral diet (67% vs 54%, P = .53).
UNASSIGNED: Osseous free tissue transfer for segmental mandibular defects remains the gold standard in reconstruction. In our patient cohort, anterior mandibular defects are associated with greater late (>90 day) complications requiring additional surgery. Comparable outcomes may be achieved with soft tissue only versus osseous free flap reconstruction of posterior mandibular defects.
UNASSIGNED: A retrospective review of patients undergoing MVFTT after segmental mandibulectomy from September 2016 to February 2021 was performed across a single academic institution. Surgical variables were collected, including the location of the resultant mandibular defect (anterior vs posterior) and flap type (osseous or non-osseous). The primary outcome variables included postoperative complications (early, <90 days; and late, >90 days) and the patients\' functional status (return to oral intake). Descriptive statistics, chi-square test, Fischer\'s exact test, and 2-sample t tests were used to analyze differences among variables.
UNASSIGNED: We analyzed a cohort of 114 consecutive patients with mandibular defects, comprising 57 anterior and 57 posterior defects. Bony free flaps with hardware were used to reconstruct 98% of anterior defects compared to 58% of posterior defects (P < .001). All soft tissue only flaps did not utilize any hardware during the reconstruction. Anterior defects demonstrated more late complications requiring additional surgery (30% vs 9%, P = .04). A secondary analysis of posterior mandibular reconstructions compared soft tissue only flaps and bony free flaps with hardware and showed equivalent rates of early (12% vs 13%, P > .99) and late (9% vs 8%, P > .99) complications requiring additional surgery while demonstrating a similar return to full oral competence (55% vs 46%, P = .52) and recovery of a 100% oral diet (67% vs 54%, P = .53).
UNASSIGNED: Osseous free tissue transfer for segmental mandibular defects remains the gold standard in reconstruction. In our patient cohort, anterior mandibular defects are associated with greater late (>90 day) complications requiring additional surgery. Comparable outcomes may be achieved with soft tissue only versus osseous free flap reconstruction of posterior mandibular defects.
摘要：
■本研究旨在评估与下颌骨切除术后微血管游离组织转移（MVFTT）后早期和晚期并发症最相关的因素。
■对2016年9月至2021年2月在一个学术机构中进行了节段性下颌骨切除术后接受MVFTT的患者的回顾性研究。收集手术变量，包括下颌骨缺损的位置（前与后）和皮瓣类型（骨或非骨）。主要结果变量包括术后并发症（早期，<90天;和迟到,>90天)和患者的功能状态(恢复口服)。描述性统计，卡方检验,费舍尔的精确测试，采用2样本t检验分析变量之间的差异。
■我们分析了114名连续的下颌骨缺损患者，包括57个前部和57个后部缺陷。带硬件的无骨皮瓣用于重建98％的前部缺损，而后部缺损为58％（P<0.001）。在重建过程中，所有仅软组织的皮瓣均未使用任何硬件。前缺损表现出更多的晚期并发症，需要额外的手术（30％vs9％，P=.04）。对下颌后重建的二次分析比较了仅软组织皮瓣和无骨性皮瓣与硬件，并显示了早期的同等率（12％vs13％，P>.99)和晚期(9%对8%，P>.99）需要额外手术的并发症，同时显示出类似的恢复到完全口腔能力（55％vs46％，P=.52）和100％口服饮食的恢复（67％vs54％，P=.53）。
■无骨组织移植治疗下颌骨节段性缺损仍是重建的金标准。在我们的患者队列中，下颌骨前缺损与更大的晚期(>90天)并发症相关,需要额外手术。仅使用软组织与无骨皮瓣重建下颌后缺损可以获得相当的结果。
■对2016年9月至2021年2月在一个学术机构中进行了节段性下颌骨切除术后接受MVFTT的患者的回顾性研究。收集手术变量，包括下颌骨缺损的位置（前与后）和皮瓣类型（骨或非骨）。主要结果变量包括术后并发症（早期，<90天;和迟到,>90天)和患者的功能状态(恢复口服)。描述性统计，卡方检验,费舍尔的精确测试，采用2样本t检验分析变量之间的差异。
■我们分析了114名连续的下颌骨缺损患者，包括57个前部和57个后部缺陷。带硬件的无骨皮瓣用于重建98％的前部缺损，而后部缺损为58％（P<0.001）。在重建过程中，所有仅软组织的皮瓣均未使用任何硬件。前缺损表现出更多的晚期并发症，需要额外的手术（30％vs9％，P=.04）。对下颌后重建的二次分析比较了仅软组织皮瓣和无骨性皮瓣与硬件，并显示了早期的同等率（12％vs13％，P>.99)和晚期(9%对8%，P>.99）需要额外手术的并发症，同时显示出类似的恢复到完全口腔能力（55％vs46％，P=.52）和100％口服饮食的恢复（67％vs54％，P=.53）。
■无骨组织移植治疗下颌骨节段性缺损仍是重建的金标准。在我们的患者队列中，下颌骨前缺损与更大的晚期(>90天)并发症相关,需要额外手术。仅使用软组织与无骨皮瓣重建下颌后缺损可以获得相当的结果。
