AI Summary & Key Takeaways
AI InsightConclusion: Our results showed that a pedicled LDMF can constitute a safe and effective alternative for the reconstruction of head and neck defects in selected patients.
📌 3 Key Takeaways
Abstract
Objective: To assess the efficacy of a modified pedicled latissimus dorsi myocutaneous flap (LDMF) in the reconstruction of defects of the head and neck region. Methods: The retrospective analysis of 17 consecutive patients operated between 2010 and 2014 in the Plastic and Reconstructive Surgery Department of a tertiary care center was performed. Among them, four (23.5%) were initially diagnosed with trauma, while 13 (76.5%) had squamous cell carcinoma originating from the head and neck region. Tumor recurrence, necrosis of the free flap, advanced age, presence of a comorbidity, and previous history of radiotherapy were indicators for a pedicled LDMF. The pedicled LDMF technique was performed via the modified subcutaneous tunnel method in all patients. Demographic, clinical, and peroperative data as well as complications in and a survey of our patients were documented. Results: Our series comprised 11 males (64.7%) and six females (35.3%); the average age was 64.29±5.43 (range, 51 to 72) years. Seroma (5/17, 29.4%) and partial flap necrosis (3/17, 17.6%) were the most common complications, while the rate of mortality during the follow-up period was 17.6% (3/17). One patient died during the early postoperative period, while two died during their oncological treatment and followup. No remarkable functional disabilities or restrictions were postoperatively observed. Conclusion: Our results showed that a pedicled LDMF can constitute a safe and effective alternative for the reconstruction of head and neck defects in selected patients. However, further controlled clinical trials on larger series are warranted to precisely unveil the indications, contraindications, and outcomes of a pedicled LDMF
Özet
Amaç: Baş-boyun bölgesi defektlerinin rekonstrüksiyonunda modifiye pediküllü latissimus dorsi kas-deri flebinin (MLDF)etkinliği değerlendirildi.Yöntemler: 2010-2014 yılları arasında kliniğimizce opere edilen 17 hasta retrospektif olarak değerlendirildi. 17 hastanın 4'ünde (%23) etken travma iken, 13 hastada (%76,5) yassı hücreli karsinom mevcuttu.Tümör rekürrensi, serbest flep kaybı, ilerlemiş yaş, ko-morbid durum varlığı ve radyoterapi hikayesi pediküllü MLDF için endikasyonları oluşturmaktaydı. Flepler modifiye subkutanöz tünel yoluyla transfer edildi. Demografik ve klinik veriler dokümante edildi. Bulgular: Klinik serimiz 11 erkek (%64,7) ve 6 kadın (%35,3) hastadan oluşmaktaydı. Yaş ortalaması 64,29±5.43 (51-72 yaş arası) idi. Seroma (5/17, %29,4) ve kısmi flep kaybı(3/17, %17,6) en sık komplikasyonlar olup, takip sürecinde mortalite oranı %17,6 (3/17) idi. İki hasta onkolojik takip döneminde, bir hasta ise ameliyat sonrası erken dönemde kaybedildi. Ameliyat sonrası anlamlı fonksiyonel kısıtlılık oluşmadı.Sonuç: Sonuçlarımız MLDF'nin baş-boyun bölgesi onarımında seçilmiş olgularda etkili ve güvenli bir tedavi seçeneği olarak kullanılabileceğini göstermektedir. Yine de endikasyon, kontraendikasyon ve sonuçların daha geniş seriler ve kontrollü randomize klinik çalışmalar ile bildirilmesi gerekmektedir