目的:颊癌的侵袭性切除同时留下口腔和面部外侧缺损。尚不清楚是否基于穿支的嵌合股前外侧(ALT)皮瓣,有肌肉成分,适用于这些复杂缺陷的重建。
方法:在这项回顾性研究中,48例颊癌(T2N0-1M0),接受了广泛的手术切除,已注册。27例使用经典ALT穿支皮瓣(经典组)进行了重建,21例使用嵌合ALT穿支皮瓣伴股外侧肌肿块(嵌合组)。伤口感染的发生率,下肢功能,面部外观,存活曲线,比较两组患者的生活质量。
结果:嵌合组伤口感染或积液的发生率低于经典组。嵌合组的美学效果优于经典组。同时,各组间供体部位的功能无显著差异。
结论:嵌合ALT穿支皮瓣,有肌肉成分,可以准确地重建口腔和侧面部缺损。它维持侧面的轮廓并降低伤口感染的发生率。
OBJECTIVE: Aggressive resection of buccal cancer simultaneously leaves both oral and lateral facial defects. It is unknown whether a perforator-based chimeric anterolateral thigh (ALT) flap, with a muscular component, is suitable for the reconstruction of these complicated defects.
METHODS: In this retrospective
study, 48 patients with a buccal carcinoma (T2 N0-1 M0), who underwent extensive surgical resection, were enrolled. Twenty-seven cases underwent reconstruction using the classical ALT perforator flap (classical group), and 21 cases used the chimeric ALT perforator flap with vastus lateralis muscle mass (chimeric group). The incidence of wound infection, lower limb extremity function, facial appearance, survival curves, and quality of life were compared between groups.
RESULTS: The incidence of wound infection or effusion was lower in the chimeric group than in the classical group. The aesthetic result achieved in the chimeric group was better than in the classical group. Meanwhile, there was no significant difference in the function of the donor site between groups.
CONCLUSIONS: The chimeric ALT perforator flap, with a muscular component, can reconstruct both the oral and lateral face defects accurately. It sustains the profile of the lateral face and decreases the incidence of wound infection.