대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)

  • 제23권1호
  • /
  • Pages.26-31
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  • 2007
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  • 1229-5183(pISSN)
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  • 2586-2553(eISSN)
대한두경부종양학회 (The Korean Society for Head and Neck Oncology)
권호 표지

두경부암종 수술 후 결손부위 재건에 사용된 유리피판술 51예의 고찰

Clinical Analysis of 51 Cases of Free Flap Reconstruction after Ablative Surgery of Head and Neck Cancer

  • 이승원 (순천향대학교 의과대학 이비인후과학교실) ;
  • 김재욱 (순천향대학교 의과대학 이비인후과학교실) ;
  • 김용배 (순천향대학교 의과대학 성형외과학교실) ;
  • 탁민성 (순천향대학교 의과대학 성형외과학교실) ;
  • 신호성 (순천향대학교 의과대학 성형외과학교실) ;
  • 장혁순 (순천향대학교 의과대학 이비인후과학교실) ;
  • 오천환 (순천향대학교 의과대학 이비인후과학교실) ;
  • 박진규 (순천향대학교 의과대학 이비인후과학교실) ;
  • 고윤우 (순천향대학교 의과대학 이비인후과학교실)
  • Lee, Seung-Won (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine) ;
  • Kim, Jae-Wook (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine) ;
  • Kim, Yong-Bae (Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine) ;
  • Tak, Min-Sung (Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine) ;
  • Shi, Ho-Sung (Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine) ;
  • Chang, Hyuck-Soon (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine) ;
  • Oh, Cheon-Hwan (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine) ;
  • Park, Jin-Gyu (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine) ;
  • Koh, Yoon-Woo (Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine)
  • 발행 : 2007.05.31
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초록

Background and Objectives：Microvascular free flap reconstruction has been revolutionized in last two decades, and became a standard option in the reconstruction of head and neck defects. We intended to review our experiences of 51 microvascular free flap for head and neck defects during 5-year period and to analyze the types of flaps according to primary sites, success and complication rates. Subjects and Methods：From Oct. 2001 through Dec. 2005, fifty one free flap reconstructions were performed in forty nine patients at ENT department of Soonchunhyang university bucheon hospital. Primary sites, pathology, T-stage, operative time, time interval of oral feeding, and various reconstructive factors such as recipient and donor vessels, free flap related complications, failure rates and salvage rates were retrospectively analyzed. The relation between complication rates and preoperative risk factors were statistically analyzed. Results：Methods of reconstruction were radial forearm free flap(RFFF)(n=28, 54.9%), anterolateral thigh free flaps(n=9, ALTFF)(17.6%), rectus abdominis free flap(n=7, RAFF)(13.7%), jejunal free flap(n=5, JFF)(9.8%), and miscellanous(n=2, 4.0%) in order. In free flap related complications, failure of free flap occurred in seven cases(13.7%) and pharyngocutaneous fistula occurred in five cases(9.8%) among fifty one free flaps. The overall success rate of free flaps was 86.3%. Salvage of free flaps was possible only one among eight cases(12.5%). In positive preoperative risk factor groups, failure of free flap was higher than in negative risk factor group. However, it was not statistically significant. Conclusion：We confirmed that free flap reconstructions are highly versatile and reliable options for use in the reconstruction of various soft tissue defects of the head and neck. Free flaps have gained great popularity given its versatility, ability for a two-team approach, and minimal donor site morbidity. However, complications related to microvascular surgery may be overcome by increased surgical experience and by intensive flap monitoring in early postoperative period.

키워드

참고문헌

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