口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (11): 1036-1038.DOI: 10.13701/j.cnki.kqyxyj.2021.11.015

• 口腔肿瘤学研究 • 上一篇    下一篇

胸背动脉穿支皮瓣修复口腔癌复发后软组织缺损的疗效分析

范腾飞1,2, 任振虎2,3*, 杨雯君2, 张胜1, 胡镜宙2, 吴汉江1, 张陈平2   

  1. 1.中南大学湘雅二医院口腔颌面外科 湖南 长沙 410011;
    2.上海交通大学医学院附属九人民医院口腔颌面-头颈肿瘤外科;上海交通大学口腔医学院国家口腔医学中心;国家口腔疾病临床医学研究中心;上海市口腔医学重点实验室 上海 200011;
    3.海南西部中心医院张志愿院士团队创新中心 海南 儋州 571700
  • 收稿日期:2021-06-07 出版日期:2021-11-28 发布日期:2021-11-22
  • 通讯作者: *任振虎,E-mail: ren.zhenhu@outlook.com
  • 作者简介:范腾飞(1985~ ),男,湖南长沙人,主治医师,博士,主要从事口腔颌面外科的临床及基础研究。
  • 基金资助:
    国家自然科学基金青年基金(编号:81802716)湖南省自然科学基金青年基金(编号:2020JJ5804)海南省卫生健康行业科研项目(编号:20A200079)湖南省卫生健康委科研计划课题项目(编号:C2019163)

Clinical Application of Thoracodorsal Artery Perforator Flaps in the Restoration of Recurrent Oral Cancer Defects

FAN Tengfei1,2, REN Zhenhu2,3*, YANG Wenjun2, ZHANG Sheng1, HU Jingzhou2, WU Hanjiang1, ZHANG Chenping2   

  1. 1. Department of Oral and Maxillofacial Surgery,The Second Xiangya Hospital of Central South University, Changsha 410011, China;
    2. Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China;
    3. Hainan Western Central Hospital, Academician Zhang Zhiyuan Team Innovation Center, Danzhou 571700, China
  • Received:2021-06-07 Online:2021-11-28 Published:2021-11-22

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摘要： 目的: 探讨口腔癌复发后软组织缺损采用胸背动脉穿支皮瓣(thoracic dorsal artery perforator flap, TDAP)修复的疗效。方法: 回顾性研究方法收集2018年1月~2020年6月口腔癌复发后行TDAP 修复术后软组织缺损的患者7例,其中6例穿支血管来自胸背动脉,1例穿支血管来自胸外侧动脉。皮瓣不带或仅携带部分背阔肌,不损伤胸背神经,切取皮瓣面积最小6 cm×12 cm, 最大8 cm×15 cm。TDAP修复舌癌术后复发2例,舌癌再发2例,颊癌再发1例,下颌牙龈癌及口底癌术后复发各1 例,所有患者无肺、肝等远处转移。结果: 7例皮瓣全部成活,皮瓣成活率 100%,无1例出现血管危像。受区与供区均一期愈合。术后随访3~10个月,皮瓣质地好,均不臃肿,不需要二期整形,皮瓣供区及肩膀关节功能良好。结论: TDAP 质地非常柔软,血管蒂长,组织量大,供区疤痕隐蔽,且供区功能损失小等优点适合用于口腔癌复发后软组织缺损的修复。

关键词: 胸背动脉穿支皮瓣, 口腔癌复发, 缺损修复

Abstract: Objective: To analyze the clinical application of thoracodorsal artery perforator flaps in the reatoration of recurrent oral cancer defects. Methods: Clinical data of 7 patients with recurrent oral cancer in Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University and Department of Oral and Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to June 2020, who were treated by thoracodorsal artery perforator flaps were analyzed retrospectively. The lateral perforator branch of dorsal thoracic artery was used as the vessel pedicle in 6 cases, and the perforator branch of serratus anterior of dorsal thoracic artery was used as the vessel pedicle in 1 cases. The flap was removed without latissimus dorsi muscle and thoracic dorsal nerve, and the area of the flap was 6 cm×12 cm to 8 cm×15 cm. There were 2 cases of recurrence of tongue cancer after TDAP repair, 2 cases of recurrence of tongue cancer, 1 case of recurrence of bucolic cancer, 1 case of recurrence of mandibular gingival cancer, and 1 case of recurrence of oral floor cancer respectively. All patients had no distant metastasis of lung or liver. Results: All 7 flaps survived, and the survival rate of flaps was 100%. Both the recipient and donor areas healed in the first stage. After 3-10 months of follow-up, the skin flap was of good texture, not bloated, no need for secondary plastic surgery, and the donor area of the skin flap and shoulder joint function were good. Conclusion: TDAP is indeed suitable for reconstruction of recurrent oral cancer defects. Due to the ductile texture of TDAP, long vascular pedicle, large tissue volume, hidden scar at the donor site, and small functional loss at the donor site, it is very conducive to the recovery of the morphology and function of recurrent oral cancer defects.

Key words: TDAP, recurrent oral cancer defects, reconstruction