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Abstract
Background
Chemoradiotherapy is a standard treatment for functional preservation in patients with advanced head and neck carcinoma. However, chemoradiotherapy increases the risk of postoperative complications.
Aims/objectives
We report the usefulness of reconstruction using a free jejunal patch flap in treating recurrence or residual head and neck carcinoma after radiotherapy. Furthermore, we investigated the factors for the occurrence of postoperative complications in patients who underwent salvage surgery using a free flap transfer.
Material and methods
This study included 41 patients with head and neck carcinoma who underwent salvage surgery using a free flap transfer, including 11 patients who underwent reconstruction using a free jejunal patch flap. Prognostic analysis was performed for the development of complications.
Results
Ten jejunal patch flaps survived without microvascular problems. One patient underwent revision reconstructive surgery because of flap failure. However, no patient had a pharyngocutaneous fistula. Oral intake could be resumed in all patients at a median 14 days postoperatively. Multivariate logistic regression analysis indicated that the use of cutaneous flaps was significantly associated with the development of complications.
Conclusions and significance
Free jejunal patch flaps can be considered useful for head and neck reconstruction after radiotherapy for early intake resumption and complication prevention.
Chinese Abstract
背景：放化疗是晚期头颈癌患者的功能保留的标准治疗方法。 然而, 放化疗会增加术后并发症风险。
目的：报告使用游离空肠补片皮瓣重建在治疗放疗后复发或残留头颈癌的有用性。 此外, 我们还调查了患者在接受使用游离皮瓣移植的挽救性手术后并发症发生的影响因素。
材料和方法：本研究纳入了 41 名头颈癌患者, 他们接受了使用游离皮瓣移植的挽救手术, 其中 11 名患者接受了使用游离空肠补片皮瓣的重建手术。 对并发症的发生进行预后分析。
结果：十个空肠补片皮瓣存活, 没有微血管问题。 一名患者接受了由于皮瓣失败而进行的修复重建手术。 然而, 没有患者出现咽皮瘘。 所有患者均可在术后中位 14 天恢复经口进食。 多变量逻辑回归分析表明皮瓣的使用与并发症的发展显著相关。
结论和意义：我们可以这么认为, 游离空肠补片皮瓣对放疗后头颈部重建以尽早恢复进食和预防并发症是有用的。