应用胸大肌皮瓣修复舌癌术后广泛缺损的探讨

目的　探讨用胸大肌岛状肌皮瓣对晚期舌癌术后广泛缺损的修复方法。方法　对 12例晚期舌癌根治切除后 ,根据其不同位置及术后缺损大小 ,采用带血管蒂的胸大肌岛状肌皮瓣以不同的方式即期修复缺损。结果　本组 12例中 ,术后肌皮瓣皮层坏死 2例 ,淋巴瘘 2例 ,吞咽障碍合并气管套管拔除困难者 1例 ,经 3月～ 12年随访 ,1例 3月后因感染出血死亡 ,2例术后 1年癌肿复发 ,1例术后 1年发生对侧颈淋巴结转移 ,其余 8例无瘤生存 3～ 12年。结论　晚期舌癌尤其是舌根癌手术切除仍为主要治疗手段之一 ,术后广泛缺损采用胸大肌岛状肌皮瓣即期修复 ,操作比较简单 ,并发症少 ,成功率较高 ,语言及吞咽功能恢复良好

Study the Ways of Repairing Large Defect after Operating on Tongue Neoplasma with Chest Skin - muscle Flaps

Objective The study the ways of repairing large defect after operation of late tongue neoplasma with islandly chest skinmuscle flaps,Methods According to different positions and size of postoperative defects area,we had repaired with different ways 12 cases of postoperative late tongue neoplasma by using islandly skin-muscle flaps with blood root.Results Of the 12 cases,2 cases happened with skin-muscle death,2 cases with lymphorrhe and 1 case with difficulty in swallowing and putting off trachea pipe.Affer the during 3 month to-12 year follow up,one died of infection and bleeding after 3 months,two had a relapse after one year,one had opposite carotid lymphatic metastasis after one year,the other eight cases lived for three to twelve years without any trouble.Conclusion One of main cure ways for late tongue neoplasma and tongue-root neoplasma is operation.Our ways of in-time repair are easier to operate had fewer complications,higher triumph rate and better resuming function of his language and swallowing.