薄型股前外侧皮瓣与前臂皮瓣修复对口腔癌手术缺损的疗效及美观度的影响

Effects of thin anterolateral thigh flap and forearm flap reconstruction on functional and aesthetic outcomes in oral cancer surgical defects

摘要:

目的 探究薄型股前外侧皮瓣与前臂皮瓣修复对口腔癌手术缺损的疗效及美观度的影响。方法 选取2021年3月—2024年3月中山市小榄人民医院和广州医科大学附属口腔医院纳入的98例口腔癌手术缺损患者作为研究对象，按手术方法分为股前组（52例）和前臂组（46例）。前臂组行前臂皮瓣修复，股前组行薄型股前外侧皮瓣修复，比较两组治疗后的临床指标、华盛顿大学生存质量评估问卷评分、美观度、术后皮瓣供区恢复情况、并发症及肿瘤局部复发情况。结果 股前组皮瓣修复术时间长于前臂组（P <0.05），缺损面积大于前臂组（P <0.05）。股前组术后皮瓣供区色素沉着率、瘢痕增生率均低于前臂组（P <0.05）。股前组并发症总发生率低于前臂组（P <0.05）；两组均无肿瘤局部复发情况。结论 薄型股前外侧皮瓣与前臂皮瓣修复对口腔癌手术缺损的疗效及美容度的影响相当，但薄型股前外侧皮瓣修复对术后皮瓣供区恢复的影响较为显著，且并发症更少。

Abstract:

Objective To investigate the effects of thin anterolateral thigh flap and forearm flap reconstruction on functional and aesthetic outcomes in oral cancer surgical defects.Methods Ninety-eight patients with oral cancer surgical defects admitted to Xiaolan People' s Hospital of Zhongshan and Affiliated Stomatology Hospital of Guangzhou Medical University between March 2021 and March 2024 were enrolled. They were divided into an anterolateral thigh group (n = 52) and a forearm group (n = 46) based on the surgical technique. The forearm group underwent forearm flap reconstruction, while the anterolateral thigh group received thin anterolateral thigh flap reconstruction. Postoperative clinical indicators, University of Washington Quality of Life Questionnaire (UW-QOL) scores, aesthetic outcomes, recovery of flap donor sites, complications, and local tumor recurrence were compared between groups.Results The operative duration was longer and the defect area was greater in the anterolateral thigh group than in the forearm group (both P < 0.05). Postoperative rates of pigmentation and scar hypertrophy were lower in the anterolateral thigh group compared with the forearm group (both P < 0.05). The overall incidence of complications was lower in the anterolateral thigh group (P < 0.05). No local tumor recurrence was observed in either group.Conclusion Thin anterolateral thigh flap and forearm flap reconstruction provide comparable functional and aesthetic outcomes for oral cancer surgical defects. However, thin anterolateral thigh flap reconstruction is associated with better postoperative donor site recovery and fewer complications.