PDF(Pubmed)
Abstract：
Introduction: Sarcoma resection often leaves patients with big defects only amenable through microsurgical reconstruction. In such cases, it is hard for the surgeon to uphold low donor-site morbidity with an aesthetic result. The purpose of this study was to investigate the clinical outcome and the patient\'s perception regarding the donor site in a cohort of patients undergoing microsurgical reconstruction with lateral thigh and lower abdominal perforator flaps. Methods: A retrospective evaluation of all patients who underwent sarcoma reconstruction with flaps harvested from the lower abdominal region (deep inferior epigastric artery perforator flap, superficial circumflex iliac artery perforator flap) or lateral thigh region (anterolateral thigh perforator flap and its variations) was performed. Only patients with defects greater than 100 cm2 were included. Patient demographics and operative variables were recorded, together with complications. Patient satisfaction and quality of life with the donor site were registered using the SCAR-Q questionnaire, which was administered at least six months post-operatively. Results: Eighteen anterolateral thigh (ALT) perforator flaps and twenty-two deep inferior epigastric artery perforator (DIEP) and superficial circumflex iliac artery perforator (SCIP) flap procedures were performed. The two groups were homogeneous for major post-operative complications (p > 0.999). Patient satisfaction with the donor site measured using the SCAR-Q questionnaire showed significantly higher scores in the DIEP/SCIP group when compared with the thigh group (p < 0.001), indicating a superiority of the lower abdominal area as an aesthetic donor site. Conclusions: The DIEP and SCIP flaps are a versatile option for reconstructing large soft-tissue defects following sarcoma resection. Therefore, flaps harvested from the lower abdomen yield a higher patient satisfaction with the donor site, which is a feature worth considering when planning a reconstructive procedure.
摘要：
简介：肉瘤切除术通常仅通过显微外科手术重建才能使具有大缺陷的患者适应。在这种情况下,对于外科医生来说，维持较低的供体部位发病率和美学效果是很困难的。这项研究的目的是调查在接受大腿外侧和下腹部穿支皮瓣显微外科重建的一组患者中的临床结果和患者对供体部位的看法。方法：回顾性评估所有从下腹部区域收获皮瓣（腹壁下深动脉穿支皮瓣，进行了旋髂浅动脉穿支皮瓣）或大腿外侧区域（股前外侧穿支皮瓣及其变异）。仅包括缺损大于100cm2的患者。记录患者的人口统计学和手术变量，连同并发症。使用SCAR-Q问卷记录患者对供体部位的满意度和生活质量，术后至少6个月给药。结果：共进行了18例股前外侧（ALT）穿支皮瓣和22例深腹下动脉穿支（DIEP）和旋髂浅动脉穿支（SCIP）皮瓣手术。两组术后主要并发症均一致（p>0.999）。使用SCAR-Q问卷测量的患者对供体部位的满意度显示，与大腿组相比，DIEP/SCIP组的得分明显更高（p<0.001），表明下腹部区域作为美学供体部位的优越性。结论：DIEP和SCIP皮瓣是重建肉瘤切除术后大型软组织缺损的通用选择。因此,从下腹部收获的皮瓣对供体部位产生更高的患者满意度，这是规划重建程序时值得考虑的一个特征。
