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논문 기본 정보

자료유형
학술저널
저자정보
Lee, Taeyul (Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine) Chung, Chulhoon (Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine) Chang, Yongjoon (Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine) Kim, Jaehyun (Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine)
저널정보
대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제42권 제5호
발행연도
2015.1
수록면
608 - 613 (6page)

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Background The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. Methods We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC flap (n=14) between 1995 and 2013. Morbidity was classified into hospitalization, medical, or flap-related complications. Functional outcomes were classified into oral re-alimentation and decannulation time. Results The overall flap-related complication rate was higher in the PMMC flap group (n=8, 57.1%; P=0.019), but the medical morbidity rate was higher in the cutaneous free flap group (n=68, 80%; P=0.006). The rate of pneumonia was higher in the cutaneous free flap group (n=48, 56.5%; P=0.020). Pulmonary premorbidity was the variable most significantly associated with pneumonia (odds ratio=3.012, P=0.012). There was no statistically significant difference in oral re-alimentation and decannulation time between the two groups. Conclusions Although the functional superiority of free flaps has been reported in many studies, our results do not support this hypothesis. One limitation of our study is the relatively smaller flap size and fewer PMMC flap cases compared with the cutaneous free flap group. The low postoperative medical morbidity incidence rate in the PMMC flap group was clinically significant; however, the free flap group had more flap-related complications. Thus, PMMC flaps should be considered a viable option, especially for patients with pulmonary premorbidities.
#Cutaneous free flap #Pectoralis major flap #Postoperative complication #Functional outcome #Hypopharynx

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참고문헌 (18)

참고문헌 신청
Bianchi B / 2012 / The free anterolateral thigh musculocutaneous flap for head and neck reconstruction : one surgeon’s experience in 92 cases / Microsurgery 32:87~95 google schola Chepeha DB / 2004 / Pectoralis major myocutaneous flap vs revascularized free tissue transfer: complications, gastrostomy tube dependence, and hospitalization / Arch Otolaryngol Head Neck Surg 130:181~186 google schola Piazza C / 2012 / Reconstructive options after total laryngectomy with subtotal or circumferential hypopharyngectomy and cervical esophagectomy / Curr Opin Otolaryngol Head Neck Surg 20:77~88 google schola Welkoborsky HJ / 2013 / Reconstruction of large pharyngeal defects with microvascular free flaps and myocutaneous pedicled flaps / Curr Opin Otolaryngol Head Neck Surg 21:318~327 google schola Han Gyeol Song / 2013 / Robot-Assisted Free Flap in Head and Neck Reconstruction / Archives of Plastic Surgery 40(4):353~358 google schola

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