Intraoral anastomosis for primary microsurgical reconstruction in patients of oral cavity malignancies: Retrospective analysis of 30 cases from a tertiary care center in India.

Autor: Garg A; Department of Surgical Oncology and Robotic Surgery, BLK-MAX Super Speciality Hospital, Pusa Road, Rajendra Place, New Delhi 110005, India. Electronic address: drgargakhil@gmail.com., Verma VK; Department of Surgical Oncology and Robotic Surgery, BLK-MAX Super Speciality Hospital, Pusa Road, Rajendra Place, New Delhi 110005, India., Kapoor R; Department of Surgical Oncology and Robotic Surgery, BLK-MAX Super Speciality Hospital, Pusa Road, Rajendra Place, New Delhi 110005, India., Dabas SK; Department of Surgical Oncology and Robotic Surgery, BLK-MAX Super Speciality Hospital, Pusa Road, Rajendra Place, New Delhi 110005, India.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2023 Oct; Vol. 85, pp. 235-241. Date of Electronic Publication: 2023 May 30.
DOI: 10.1016/j.bjps.2023.05.054
Abstrakt: Introduction: In patients undergoing either robotic neck dissection or no neck dissection, the neck recipient vessels for the free flaps remain unexposed. Intraoral vessels have been successfully used as microvascular recipients but their use in intraoral malignancies is uncommon. We describe our initial experience of using intraoral recipients in 30 patients with oral cavity malignancies.
Methods: For this retrospective observational study, the hospital records of all patients who underwent microvascular reconstruction using intraoral recipient vessels over a 14-month period at a tertiary care hospital in India were studied. Patient demographics, disease profile, details of oncosurgical resection, reconstructive procedure details, and postoperative recovery data were analyzed.
Results: Intraoral anastomosis was successfully performed in 30 patients. The average patient was middle-aged (mean age 54 years) and male (26/30). Location of the postexcision defect was the buccal mucosa in 16/30 and the tongue in 12/30 patients. Anterolateral thigh flap (ALT) was used in 28/30 patients. Recipient vessels were facial vessels in 24/30 patients and lingual vessels in 6/30 patients. Venous anastomotic coupler was used in 27/30 patients. Three patients underwent re-exploration for flap congestion with loss of flap in 2/30 patients.
Conclusion: The intraoral approach offers consistent vascular anatomy and can be performed without any external incision and oro-cervical tunneling. Being technically challenging, it has an initial learning phase. Adequate mouth opening and preservation of recipient vessels during excision and neck dissection are important prerequisites. This approach can offer a scarless reconstruction, which can improve the psycho-social rehabilitation of the patients.
Competing Interests: Declaration of Competing Interest None of the authors declare any conflict of interest.
(Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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